MEDICARE: OHIOHEALTH CORPORATION

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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1760103097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIOHEALTH CORPORATION

Provider Business Mailing Address
First Line	:	5150 E DUBLIN GRANVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43081-8701
Country	:	US
Telephone Number	:	614-788-8600
Fax Number	:	614-566-6999

Provider Business Practice Location Address
First Line	:	5150 E DUBLIN GRANVILLE RD STE 140
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43081-8701
Country	:	US
Telephone Number	:	614-788-8600
Fax Number	:

Authorized Official
Title or Position	:	PHARMACY SITE MANAGER
Name	:	SHANNON KEYS
Credential	:	PHARMD
Telephone Number	:	614-566-2927

Provider Enumeration Date	:	09/06/2022
Last Update Date	:	03/22/2024

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Directions to “OHIOHEALTH CORPORATION ” Practice Location

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