1891839585 NPI number — UNIVERSITY HEALTH CONNECTION PHARMACY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891839585 NPI number — UNIVERSITY HEALTH CONNECTION PHARMACY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY HEALTH CONNECTION PHARMACY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891839585
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1581 DODD DR
Provider Second Line Business Mailing Address:
MCCAMPBELL HALL, ROOM 216
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43210-1257
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-685-6473
Provider Business Mailing Address Fax Number:
614-688-0720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1581 DODD DR
Provider Second Line Business Practice Location Address:
MCCAMPBELL HALL, ROOM 216
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43210-1257
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-685-6473
Provider Business Practice Location Address Fax Number:
614-688-0720
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GREEN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
GEORGE
Authorized Official Title or Position:
PHARMACIST IN CHARGE
Authorized Official Telephone Number:
614-685-6473

Provider Taxonomy Codes

  • Taxonomy code: 3336C0002X , with the licence number:  02-1393900 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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