Provider Demographics
NPI:1962901314
Name:COLUMBUS PHARMACY, INC
Entity type:Organization
Organization Name:COLUMBUS PHARMACY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-371-6843
Mailing Address - Street 1:246 LINCOLN CIR STE B
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-3090
Mailing Address - Country:US
Mailing Address - Phone:614-371-6843
Mailing Address - Fax:614-737-9883
Practice Address - Street 1:246 LINCOLN CIR STE B
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3090
Practice Address - Country:US
Practice Address - Phone:614-371-6843
Practice Address - Fax:614-737-9883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPMY.022834500-0333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175767OtherPK