Mediserv Short North Phcy Inc

Primary specialty

Clinic PharmacyTaxonomy code 3336C0002X

Legal business name

MEDISERV SHORT NORTH PHCY INC

Practice address

21 W Hubbard Ave
Ste B
Columbus, OH 43215-1474

Phone

(614) 294-6231

Fax

(614) 294-6223

NPI assigned

Nov 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tracy Hammond

Title

Third Party Admin

Phone

(614) 481-4272

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• MEDISERV SHORT NORTH PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1659459162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 W HUBBARD AVE",
            "address_2": "STE B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 W HUBBARD AVE",
            "address_2": "STE B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151474",
            "telephone_number": "614-294-6231",
            "fax_number": "614-294-6223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDISERV SHORT NORTH PHCY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "HAMMOND",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "THIRD PARTY ADMIN",
        "authorized_official_telephone_number": "614-481-4272"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2605701",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3673779",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDISERV SHORT NORTH PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.