Healthcare Provider Details

I. General information

NPI: 1255866497
Provider Name (Legal Business Name): KELLY JOHNSTON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3975 POWELL RD
POWELL OH
43065-7979
US

IV. Provider business mailing address

3975 POWELL RD
POWELL OH
43065-7979
US

V. Phone/Fax

Practice location:
  • Phone: 614-889-5257
  • Fax: 614-889-5320
Mailing address:
  • Phone: 614-889-5257
  • Fax: 614-889-5320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03324221
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: