Provider Demographics
NPI:1174210769
Name:OHIOHEALTH SPECIALTY PHARMACY
Entity type:Organization
Organization Name:OHIOHEALTH SPECIALTY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY SITE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:KEYS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-566-2927
Mailing Address - Street 1:3545 OLENTANGY RIVER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3945
Mailing Address - Country:US
Mailing Address - Phone:614-566-3322
Mailing Address - Fax:614-566-6999
Practice Address - Street 1:3545 OLENTANGY RIVER RD STE 100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3945
Practice Address - Country:US
Practice Address - Phone:614-566-3322
Practice Address - Fax:614-566-6999
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO HEALTH CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy