Provider Demographics
NPI:1134122609
Name:HEALTHMED PHARMACY WEST,LLC
Entity Type:Organization
Organization Name:HEALTHMED PHARMACY WEST,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUBMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-228-6620
Mailing Address - Street 1:2800 WEST BROAD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204
Mailing Address - Country:US
Mailing Address - Phone:614-276-8500
Mailing Address - Fax:614-308-0920
Practice Address - Street 1:2800 W BROAD ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2641
Practice Address - Country:US
Practice Address - Phone:614-276-8500
Practice Address - Fax:614-308-0920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2354367Medicaid
OH3670975OtherNABP