Provider Demographics
NPI:1275961989
Name:THE OHIO STATE UNIVERSITY
Entity Type:Organization
Organization Name:THE OHIO STATE UNIVERSITY
Other - Org Name:MEDICATION MANAGEMENT PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICATION MANAGEMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:M
Authorized Official - Last Name:SWEANEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:614-292-1126
Mailing Address - Street 1:500 W 12TH AVE
Mailing Address - Street 2:138B PARKS HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1214
Mailing Address - Country:US
Mailing Address - Phone:614-292-1126
Mailing Address - Fax:
Practice Address - Street 1:500 W 12TH AVE
Practice Address - Street 2:138B PARKS HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1214
Practice Address - Country:US
Practice Address - Phone:614-292-1126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0223489003336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy