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General NPI Number Information
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NPI Number | 1104840420
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Entity Type | Individual
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Provider Name | JARROD WARREN GROSSMAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2865 W BROAD ST PHARMACY
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City | COLUMBUS
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State | OH
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Zip | 43204-2643
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Country | US
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Telephone | 614-351-0062
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Fax | 614-351-0358
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Provider Business Mailing Address
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Address Line | 1583 PRESIDENTIAL DR APT A4
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City | COLUMBUS
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State | OH
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Zip | 43212-1268
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Country | US
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Telephone | 614-506-5690
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 03-1-27183
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License Number State | OH
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