Healthcare Provider Details

I. General information

NPI: 1518493964
Provider Name (Legal Business Name): GARRETT KOSS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2017
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 STONERIDGE DR
GAHANNA OH
43230-8701
US

IV. Provider business mailing address

1365 STONERIDGE DR
GAHANNA OH
43230-8701
US

V. Phone/Fax

Practice location:
  • Phone: 614-418-1531
  • Fax:
Mailing address:
  • Phone: 614-418-1531
  • Fax: 615-416-2058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03129708
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: