Healthcare Provider Details

I. General information

NPI: 1730440678
Provider Name (Legal Business Name): OHIOHEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 POLARIS PKWY
WESTERVILLE OH
43082-8019
US

IV. Provider business mailing address

260 POLARIS PKWY
WESTERVILLE OH
43082-8019
US

V. Phone/Fax

Practice location:
  • Phone: 614-533-3535
  • Fax: 614-533-3536
Mailing address:
  • Phone: 614-533-3535
  • Fax: 614-533-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberRTP022218250
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EVA BRAHIMAJ
Title or Position: PHARMACY SUPERVISOR
Credential:
Phone: 614-533-3534