# COUNTY LINEPROFESSIONAL PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Medicine Shoppe Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710055959
- **Authorized official:** SCOTT PODOLAN RPH (OWNER AND PHARMACIST)
- **Authorized official phone:** (614) 865-2577

## Contact information

- **Practice address:** 1020 HIGH ST, WORTHINGTON, OH 43085-4014
- **Practice address phone:** (614) 865-2577
- **Practice address fax:** (614) 882-9546
- **Mailing address:** 1020 HIGH ST, WORTHINGTON, OH 43085-4014
- **Mailing address phone:** (614) 865-2577
- **Mailing address fax:** (614) 882-9546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 021418350 | OH | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 12/04/2006
- **Last updated:** 07/05/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2079666 | PK | — |
| 05 | — | 2460395 | — | OH |