MEDICARE: COMPDRUG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2800X	Methadone Clinic
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1316498207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPDRUG

Provider Business Mailing Address
First Line	:	1410 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2760
Country	:	US
Telephone Number	:	614-224-4506
Fax Number	:	614-291-0118

Provider Business Practice Location Address
First Line	:	1410 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43211-2760
Country	:	US
Telephone Number	:	614-224-4506
Fax Number	:	614-291-0118

Authorized Official
Title or Position	:	CEO
Name	:	ANTHONY D. METS
Credential	:
Telephone Number	:	614-224-4506

Provider Enumeration Date	:	10/17/2016
Last Update Date	:	12/05/2016

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Directions to “COMPDRUG ” Practice Location

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