Healthcare Provider Details

I. General information

NPI: 1518968668
Provider Name (Legal Business Name): DRUG STORE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2940 GROVEPORT RD
COLUMBUS OH
43207-3255
US

IV. Provider business mailing address

2940 GROVEPORT RD
COLUMBUS OH
43207-3255
US

V. Phone/Fax

Practice location:
  • Phone: 614-491-3446
  • Fax: 614-497-7962
Mailing address:
  • Phone: 614-491-3446
  • Fax: 614-491-7783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRTP020113350
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY SLOAN
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 614-868-1685