MEDICARE: COLUMBUS FAMILY PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1730423534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS FAMILY PHARMACY

Provider Business Mailing Address
First Line	:	5264 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4737
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5264 CLEVELAND AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4737
Country	:	US
Telephone Number	:	313-318-8900
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ALI FAKIH
Credential	:
Telephone Number	:	313-318-8900

Provider Enumeration Date	:	11/16/2012
Last Update Date	:	11/16/2012

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Directions to “COLUMBUS FAMILY PHARMACY ” Practice Location

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