Organization
MAPLE LEAF HILLTOP PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH A JERKINS PHARMD (OWNER)
(614) 272-6791
Entity
Organization
Contact information
Practice address
2575 W BROAD ST, COLUMBUS, OH 43204-3333
(614) 272-8188
(614) 272-8311
Mailing address
2575 W BROAD ST, COLUMBUS, OH 43204-3333
(614) 272-8188
(614) 272-8311
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
022170700
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022170700
OHIO STATE BOARD OF PHARMACY
OH
Enumeration date
11/09/2011
Last updated
11/09/2011
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