Healthcare Provider Details

I. General information

NPI: 1851247175
Provider Name (Legal Business Name): THOMAS KELLETT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: TOM KELLETT PHARMD

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N CHILLICOTHE ST
PLAIN CITY OH
43064-1045
US

IV. Provider business mailing address

2611 DEMING AVE
COLUMBUS OH
43202-2417
US

V. Phone/Fax

Practice location:
  • Phone: 614-733-3784
  • Fax: 614-721-7996
Mailing address:
  • Phone: 614-579-6254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03440140
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: