Healthcare Provider Details

I. General information

NPI: 1174314421
Provider Name (Legal Business Name): OHIOHEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 E WILSON BRIDGE RD STE B2
WORTHINGTON OH
43085-2369
US

IV. Provider business mailing address

404 E WILSON BRIDGE RD STE B2
WORTHINGTON OH
43085-2369
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-3322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SHANNON KEYS
Title or Position: PHARMACY SITE MANAGER
Credential: PHARMD
Phone: 614-566-2927