Provider Demographics
NPI:1699533059
Name:HEART OF OHIO FAMILY HEALTH AT CAPITAL PARK PHARMACY
Entity type:Organization
Organization Name:HEART OF OHIO FAMILY HEALTH AT CAPITAL PARK PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:YAMMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-235-5555
Mailing Address - Street 1:5000 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2440
Mailing Address - Country:US
Mailing Address - Phone:614-235-5555
Mailing Address - Fax:614-536-1994
Practice Address - Street 1:2365 INNIS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-3730
Practice Address - Country:US
Practice Address - Phone:614-235-5555
Practice Address - Fax:614-536-1994
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEART OF OHIO FAMILY HEALTH PHARMACIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-11
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy