Healthcare Provider Details

I. General information

NPI: 1295211597
Provider Name (Legal Business Name): ANDREW STEPHEN FAIELLA PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2018
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1957 OHIO DR
GROVE CITY OH
43123-4835
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-366-5671
  • Fax:
Mailing address:
  • Phone: 614-366-5671
  • Fax: 614-688-7581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03334857
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: