Provider Demographics
NPI:1811337363
Name:THE PHARMACY COUNTER, LLC
Entity type:Organization
Organization Name:THE PHARMACY COUNTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:BODENSTEDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-473-1493
Mailing Address - Street 1:PO BOX 636599
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6599
Mailing Address - Country:US
Mailing Address - Phone:419-473-1493
Mailing Address - Fax:
Practice Address - Street 1:2142 N COVE BLVD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3895
Practice Address - Country:US
Practice Address - Phone:419-291-5418
Practice Address - Fax:419-479-6927
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMEDICA PHYSICIAN & CONTINUUM SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-28
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy