Provider Demographics
NPI:1285731117
Name:TREMONT PHARMACY INC
Entity type:Organization
Organization Name:TREMONT PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MEREDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-488-2625
Mailing Address - Street 1:2144 TREMONT CTR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3110
Mailing Address - Country:US
Mailing Address - Phone:614-488-2625
Mailing Address - Fax:614-488-0474
Practice Address - Street 1:2144 TREMONT CTR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3110
Practice Address - Country:US
Practice Address - Phone:614-488-2625
Practice Address - Fax:614-488-0474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OH0205298003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2121047OtherPK
3620665OtherNCPDP PROVIDER IDENTIFICATION NUMBER