Healthcare Provider Details

I. General information

NPI: 1699533059
Provider Name (Legal Business Name): HEART OF OHIO FAMILY HEALTH AT CAPITAL PARK PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2024
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 INNIS RD
COLUMBUS OH
43224-3730
US

IV. Provider business mailing address

5000 E MAIN ST
COLUMBUS OH
43213-2440
US

V. Phone/Fax

Practice location:
  • Phone: 614-235-5555
  • Fax: 614-536-1994
Mailing address:
  • Phone: 614-235-5555
  • Fax: 614-536-1994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: YAMMAH MORGAN
Title or Position: COO
Credential:
Phone: 614-235-5555