Healthcare Provider Details

I. General information

NPI: 1356870281
Provider Name (Legal Business Name): KELLY ANN BANDY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2017
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3637 S HIGH ST
COLUMBUS OH
43207-4009
US

IV. Provider business mailing address

8401 UNION DR
GALLOWAY OH
43119-8125
US

V. Phone/Fax

Practice location:
  • Phone: 614-492-1081
  • Fax: 614-748-1093
Mailing address:
  • Phone: 614-571-3938
  • Fax: 614-748-1093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number030120898
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: