Provider Demographics
NPI:1639586498
Name:UPTOWN PHARMACY LLC
Entity Type:Organization
Organization Name:UPTOWN PHARMACY LLC
Other - Org Name:MEDICATION CONSULTANTS OF CENTRAL OHIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JARRETT
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:BAUDER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:614-882-2392
Mailing Address - Street 1:23 N. STATE ST.
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2113
Mailing Address - Country:US
Mailing Address - Phone:614-882-2392
Mailing Address - Fax:614-882-2399
Practice Address - Street 1:23 N STATE ST
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2113
Practice Address - Country:US
Practice Address - Phone:614-882-2392
Practice Address - Fax:614-882-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-14
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03233874261Q00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No291U00000XLaboratoriesClinical Medical Laboratory