Healthcare Provider Details

I. General information

NPI: 1760770069
Provider Name (Legal Business Name): JAIME CAPESTANY R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 W BROAD ST
COLUMBUS OH
43204-3783
US

IV. Provider business mailing address

2 MIRANOVA PL STE 500
COLUMBUS OH
43215-7052
US

V. Phone/Fax

Practice location:
  • Phone: 614-645-2308
  • Fax:
Mailing address:
  • Phone: 614-321-9743
  • Fax: 614-647-0070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03323314
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: