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Organization
FAMILY MED-MART LLC
Active
Organization
FAMILY MED-MART LLC
Active
Other names
Whitehall Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
YAMROTE LAKEW (MANAGING MEMBER/AGENT)
(614) 598-3001
Entity
Organization
Contact information
Practice address
4770 INDIANOLA AVE STE 208, COLUMBUS, OH 43214-1876
(614) 547-7766
(614) 547-7742
Mailing address
2833 BRYN MAWR DR, LEWIS CENTER, OH 43035-8915
(614) 598-3001
(614) 547-7742
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
022659650
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2127361
PK
—
05
—
3090542
—
OH
Enumeration date
09/28/2010
Last updated
03/29/2017
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