<Unavail>
LBN: Providence Family Pharmacy Llc
<Unavail> is an health care organization with primary practice located at 2500 W Silver Spring Dr , Glendale WI 53209-4218. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Providence Family Pharmacy Llc can be contacted via phone (414) 885-0550, or through Okusanya, Abiola via phone (414) 885-0550.
Contact Information
Primary practice address
2500 W Silver Spring Dr
Glendale WI 53209-4218
Phone: (414) 885-0550
Fax: (414) 885-0552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 9428-42 | Wisconsin |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1386190247 |
|---|---|
| LBN Legal business name | Providence Family Pharmacy Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Okusanya, Abiola |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 31st, 2016 |
| Last updated | Feb 20th, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386190247 | NPPES |
| Other | 2163951 | PK |
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