County Lineprofessional Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

021418350 Issued in OH

Legal business name

COUNTY LINEPROFESSIONAL PHARMACY LLC

Doing business as

The Medicine Shoppe Pharmacy

Practice address

1020 High St
Worthington, OH 43085-4014

Phone

(614) 865-2577

Fax

(614) 882-9546

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Scott Podolan, RPH

Title

Owner and Pharmacist

Phone

(614) 865-2577

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• The Medicine Shoppe Pharmacy Doing business as

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1710055959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 HIGH ST",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854014",
            "telephone_number": "614-865-2577",
            "fax_number": "614-882-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 HIGH ST",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430854014",
            "telephone_number": "614-865-2577",
            "fax_number": "614-882-9546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY LINEPROFESSIONAL PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "PODOLAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER AND PHARMACIST",
        "authorized_official_telephone_number": "614-865-2577",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "021418350",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2079666",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2460395",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medicine Shoppe Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Worthington, OH
• Providers in Worthington, OH by specialty
• Community/Retail Pharmacy in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.