Maple Leaf New Rome Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

022295450 Issued in OH

Legal business name

MAPLE LEAF NEW ROME PHARMACY

Practice address

5212 W Broad St
Columbus, OH 43228-1642

Phone

(614) 851-5811

Fax

(614) 851-5815

NPI assigned

Apr 11, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Jerkins, PHARM.D

Title

Owner

Phone

(614) 272-6791

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1912340795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27005",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432270005",
            "telephone_number": "614-272-6791",
            "fax_number": "614-272-6826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5212 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281642",
            "telephone_number": "614-851-5811",
            "fax_number": "614-851-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE LEAF NEW ROME PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-11",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "JERKINS",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-272-6791",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OH",
            "license": "022295450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TERMINAL DISBRIBUTOR OF DANGEROUS DRUGS LICENSE",
            "identifier": "022295450",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Columbus, OH
• Providers in Columbus, 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 Apr 11, 2013; 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.