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Organization
COUNTY LINEPROFESSIONAL PHARMACY LLC
Active
Organization
COUNTY LINEPROFESSIONAL PHARMACY LLC
Active
Other names
The Medicine Shoppe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT PODOLAN RPH (OWNER AND PHARMACIST)
(614) 865-2577
Entity
Organization
Contact information
Practice address
1020 HIGH ST, WORTHINGTON, OH 43085-4014
(614) 865-2577
(614) 882-9546
Mailing address
1020 HIGH ST, WORTHINGTON, OH 43085-4014
(614) 865-2577
(614) 882-9546
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
021418350
OH
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2079666
PK
—
05
—
2460395
—
OH
Enumeration date
12/04/2006
Last updated
07/05/2016
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