Healthcare Provider Details

I. General information

NPI: 1790726206
Provider Name (Legal Business Name): JEFF'S FAMILY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W PIKE ST
MORROW OH
45152-1107
US

IV. Provider business mailing address

101 W PIKE ST
MORROW OH
45152-1107
US

V. Phone/Fax

Practice location:
  • Phone: 513-899-4074
  • Fax: 513-899-3783
Mailing address:
  • Phone: 513-899-4074
  • Fax: 513-899-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JEFFERY P. BUTCHER
Title or Position: OWNER
Credential:
Phone: 513-899-4074