Healthcare Provider Details

I. General information

NPI: 1447243290
Provider Name (Legal Business Name): NICHOLAS ANTHONY VOTOLATO RPH BCPP
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 UPHAM DR
COLUMBUS OH
43210-1250
US

IV. Provider business mailing address

5225 ARYSHIRE DR
DUBLIN OH
43017-8675
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-4876
  • Fax: 614-293-4886
Mailing address:
  • Phone: 614-766-9626
  • Fax: 614-293-4886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License Number03110974
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: