Healthcare Provider Details

I. General information

NPI: 1669498788
Provider Name (Legal Business Name): MBR PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 GEORGESVILLE RD
COLUMBUS OH
43228-2420
US

IV. Provider business mailing address

4600 ARROWHEAD RD
POWELL OH
43065-8949
US

V. Phone/Fax

Practice location:
  • Phone: 614-279-9368
  • Fax: 614-279-9404
Mailing address:
  • Phone: 614-203-2301
  • Fax: 614-792-0483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberRTP021571750
License Number StateOH

VIII. Authorized Official

Name: MARY RIEGLE
Title or Position: PRST OWNER AND PHARMACIST
Credential:
Phone: 614-203-2301