Organization
MEDISERV CLEVELAND PHCY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY HAMMOND (THIRD PARTY ADMIN)
(614) 481-4272
Entity
Organization
Contact information
Practice address
1570 CLEVELAND AVE, COLUMBUS, OH 43211-2755
(614) 294-2642
(614) 294-2645
Mailing address
1570 CLEVELAND AVE, COLUMBUS, OH 43211-2755
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0999291
—
OH
01
—
3660330
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/01/2006
Last updated
09/11/2025
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