Provider Demographics
NPI:1437705068
Name:GOODMED PHARMACY, LLC
Entity Type:Organization
Organization Name:GOODMED PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEINOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-434-2448
Mailing Address - Street 1:2287 ELLSWORTH RD STE A
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4805
Mailing Address - Country:US
Mailing Address - Phone:734-434-2448
Mailing Address - Fax:734-434-2458
Practice Address - Street 1:3433 AGLER RD STE 1150
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3681
Practice Address - Country:US
Practice Address - Phone:614-476-6336
Practice Address - Fax:614-476-6393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000279161OtherBOARD OF PHARMACY LICENSE