Provider Demographics
NPI:1265998025
Name:POWELL PHARMACY INC
Entity type:Organization
Organization Name:POWELL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TUBUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-493-7570
Mailing Address - Street 1:4004 PRESIDENTIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8440
Mailing Address - Country:US
Mailing Address - Phone:614-636-4499
Mailing Address - Fax:
Practice Address - Street 1:4004 PRESIDENTIAL PKWY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8440
Practice Address - Country:US
Practice Address - Phone:614-636-4499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy