Healthcare Provider Details

I. General information

NPI: 1932296134
Provider Name (Legal Business Name): MAPLE LEAF PHARMACY EAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 S JAMES RD
COLUMBUS OH
43227-1069
US

IV. Provider business mailing address

935 S JAMES RD
COLUMBUS OH
43227-1069
US

V. Phone/Fax

Practice location:
  • Phone: 614-586-1553
  • Fax: 614-586-1556
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOSEPH JERKINS
Title or Position: PHARMACIST OWNER
Credential:
Phone: 614-239-7560