Healthcare Provider Details
I. General information
NPI: 1952347445
Provider Name (Legal Business Name): OSU STUDENT HEALTH CENTER PHCY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/21/2006
Last Update Date: 09/19/2025
Certification Date: 09/21/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1875 MILLIKIN RD
COLUMBUS OH
43210-2200
US
IV. Provider business mailing address
1875 MILLIKIN RD
COLUMBUS OH
43210-2200
US
V. Phone/Fax
- Phone: 614-292-0125
- Fax: 614-292-4790
- Phone: 614-292-4025
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0002X |
| Taxonomy | Clinic Pharmacy |
| License Number | PMY.020133600-03 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PHILLIP
ANDERSON
Title or Position: DIR OF PHCY
Credential:
Phone: 614-292-4592