Healthcare Provider Details

I. General information

NPI: 1467348615
Provider Name (Legal Business Name): GRANT HALSEY WENDEL PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2025
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205-2639
US

IV. Provider business mailing address

6426 ANTHONY MARTIN APT 306
NEW ALBANY OH
43054-3542
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-9199
  • Fax:
Mailing address:
  • Phone: 513-258-3019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03445414
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: