Provider Demographics
NPI:1336712884
Name:DOCTORS PHARMACY DOWNTOWN
Entity Type:Organization
Organization Name:DOCTORS PHARMACY DOWNTOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:614-562-9101
Mailing Address - Street 1:270 S GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5334
Mailing Address - Country:US
Mailing Address - Phone:614-562-9101
Mailing Address - Fax:614-706-4594
Practice Address - Street 1:270 S GRANT AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5334
Practice Address - Country:US
Practice Address - Phone:614-562-9101
Practice Address - Fax:614-706-4594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy