Provider Demographics
NPI:1790172146
Name:PICKERINGTON EMERGENCY CARE CENTER PHARMACY
Entity Type:Organization
Organization Name:PICKERINGTON EMERGENCY CARE CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, RPH
Authorized Official - Phone:740-438-6907
Mailing Address - Street 1:1010 REFUGEE RD
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9653
Mailing Address - Country:US
Mailing Address - Phone:614-788-4191
Mailing Address - Fax:614-788-4199
Practice Address - Street 1:1010 REFUGEE RD
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9653
Practice Address - Country:US
Practice Address - Phone:614-788-4191
Practice Address - Fax:614-788-4199
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OHIO HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRTP 02250265003261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care