Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Pharmacy Inc

Organization Community/Retail Pharmacy · NPI 1942436027

Providence Pharmacy Inc is a Community/Retail Pharmacy in Fairburn, Georgia. Works from 2 locations. Registered with an NPI since 2009.

In the registry since
2009
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

180 W Broad St Ste A
Fairburn, GA 30213
Phone: (678) 489-2069
Fax: (678) 489-8627
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 180 W Broad St Ste A, Fairburn, GA 30213 — (678) 489-2069

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X

Record details

NPI number1942436027
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Clement Okpala — Ceo · (678) 489-2069
Other names Providence Pharmacy
NPI enumeratedJune 3, 2009
Last updated in NPPESMarch 11, 2021
Certification dateMarch 11, 2021
Mailing address180 W Broad St Ste A, Fairburn, GA 30213