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General NPI Number Information
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NPI Number | 1962584763
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Entity Type | Organization
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Legal Business Name | CLINIC PHARMACY INC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 1000 E BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43205-1381
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Country | US
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Telephone | 614-252-4348
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Fax | 614-252-5079
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Provider Business Mailing Address
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Address Line | 1000 E BROAD ST
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City | COLUMBUS
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State | OH
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Zip | 43205-1381
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Country | US
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Telephone | 614-252-4348
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Fax | 614-252-5079
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Authorized Official
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Title or Position | PRES
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Name | JOHN PETRIE
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Credential |
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Telephone | 614-252-4348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RTP02047190003
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License Number State | OH
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