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Organization
MAPLE LEAF GROUP
Active
Organization
MAPLE LEAF GROUP
Active
Other names
MAPLE LEAF PHARMACY WEST
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH JERKINS RPH (OWNER)
(614) 272-6791
Entity
Organization
Contact information
Practice address
2575 W BROAD ST STE 5, COLUMBUS, OH 43204-3333
(614) 274-5890
(614) 274-5899
Mailing address
PO BOX 27005, COLUMBUS, OH 43227-0005
(614) 274-5890
(614) 443-1020
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PMY.021746200-03
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2081077
PK
—
05
—
2772629
—
OH
Enumeration date
09/10/2007
Last updated
09/19/2025
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