Provider Demographics
NPI:1699344408
Name:CORDANT PHARMACY OHIO, LLC
Entity type:Organization
Organization Name:CORDANT PHARMACY OHIO, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF STAFF
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ECKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-314-0146
Mailing Address - Street 1:12015 E 46TH AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-3107
Mailing Address - Country:US
Mailing Address - Phone:614-245-0347
Mailing Address - Fax:
Practice Address - Street 1:3720 RIDGE MILL DR STE B
Practice Address - Street 2:
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-9836
Practice Address - Country:US
Practice Address - Phone:844-848-5955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy