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General NPI Number Information
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NPI Number | 1740833748
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Entity Type | Individual
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Provider Name | EVAN MICHAEL MURTHA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 1464 CLEVELAND AVE
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City | COLUMBUS
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State | OH
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Zip | 43211-2760
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Country | US
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Telephone | 614-298-4190
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Fax | 614-298-4191
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Provider Business Mailing Address
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Address Line | 591 HAVERSHAM DR
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City | GAHANNA
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State | OH
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Zip | 43230-2213
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Country | US
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Telephone | 614-209-2761
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03438799
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License Number State | OH
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