Healthcare Provider Details

I. General information

NPI: 1962901314
Provider Name (Legal Business Name): COLUMBUS PHARMACY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 LINCOLN CIR STE B
GAHANNA OH
43230-3090
US

IV. Provider business mailing address

246 LINCOLN CIR STE B
GAHANNA OH
43230-3090
US

V. Phone/Fax

Practice location:
  • Phone: 614-371-6843
  • Fax: 614-737-9883
Mailing address:
  • Phone: 614-371-6843
  • Fax: 614-737-9883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPMY.022834500-0
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JOSE TORRES
Title or Position: OWNER
Credential:
Phone: 614-371-6843