Healthcare Provider Details

I. General information

NPI: 1841923786
Provider Name (Legal Business Name): JARED MICHAEL REPAS PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 04/13/2025
Certification Date: 04/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1177 POLARIS PKWY
COLUMBUS OH
43240-6000
US

IV. Provider business mailing address

4951 STRATFORD PINE LN
DUBLIN OH
43016-9456
US

V. Phone/Fax

Practice location:
  • Phone: 614-430-2445
  • Fax:
Mailing address:
  • Phone: 440-222-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03442060
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: