Healthcare Provider Details

I. General information

NPI: 1386179182
Provider Name (Legal Business Name): MICHAEL GRUMBLE PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2017
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 E LONG ST
COLUMBUS OH
43203-1845
US

IV. Provider business mailing address

736 E LONG ST
COLUMBUS OH
43203-1845
US

V. Phone/Fax

Practice location:
  • Phone: 614-300-2334
  • Fax: 614-300-3172
Mailing address:
  • Phone: 614-300-2334
  • Fax: 614-300-3172

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03334820
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: