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NPI 1235596990

NPI 1235596990 : OHIO STATE UNIVERSITY OUTPATIENT PHARMACY : COLUMBUS, OH

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General NPI Number Information
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    NPI Number           |    1235596990
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    Entity Type          |    Organization 
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    Legal Business Name  |    OHIO STATE UNIVERSITY OUTPATIENT PHARMACY 
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Dates
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    Enumeration Date     |    01/26/2016
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    Last Update Date     |    02/02/2026
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Provider Practice Location Address
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    Address Line         |    460 W 10TH AVE RM L012 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43210-1240
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    Country              |    US
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    Telephone            |    614-293-5920
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    Fax                  |    614-366-0097
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Provider Business Mailing Address
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    Address Line         |    460 W 10TH AVE RM L012E 
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    City                 |    COLUMBUS
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    State                |    OH
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    Zip                  |    43210-1240
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    Country              |    US
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    Telephone            |    614-293-5920
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    Fax                  |    614-366-0097
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Authorized Official
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    Title or Position    |    CHIEF PHARMACY OFFICER
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    Name                 |    DR. TRISHA  JORDAN 
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    Credential           |    PHARMD
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    Telephone            |    614-293-8470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    3336S0011X
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    Taxonomy Name        |    Specialty Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    333600000X
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    Taxonomy Name        |    Pharmacy
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    3336C0003X
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    Taxonomy Name        |    Community/Retail Pharmacy
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    License Number       |    22593850
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    License Number State |    OH
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