MAPLE LEAF COMPOUNDING PHARMACY (NPI# 1578905147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578905147 |
| Entity Type | Organization |
| Organization Name | MAPLE LEAF COMPOUNDING PHARMACY |
| Practice Address |
2575 W Broad St Columbus OH 43204-3333 |
| Practice Telephone | 6142726791 |
| Practice Fax Number | 6142726826 |
| Mailing Telephone | 6142726791 |
| Mailing Fax Number | 6142726826 |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |
| Authorized Official Name | MR. JOSEPH JERKINS (OWNER/RESPONSIBLE PHARMACIST) |
| Authorized Official Telephone | 6142726791 |
| Authorized Official Credential | PHARM.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
022325150 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | OHIO STATE BOARD OF PHARMACY LICENSE | 022325150 | 01 |
| Street Address |
2575 W BROAD ST |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43204-3333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578599171 | Buckeye Family Medicine Inc | Family Medicine | 2575 W Broad St, Columbus, OH 43204-3333 | 2006-06-24 |
| 1992304364 | Samuel Dwomoh | Pharmacist | 2575 W Broad St, Columbus, OH 43204-3333 | 2020-10-18 |
| 1730796129 | Five Points Recovery LLC | Community/Behavioral Health | 2575 W Broad St, Columbus, OH 43204-3333 | 2020-09-29 |
| 1730792524 | Five Points Recovery LLC | Clinic/Center | 2575 W Broad St, Columbus, OH 43204-3333 | 2020-08-31 |
| 1821629932 | Doctors Pharmacy Hilltop LLC | Pharmacy | 2575 W Broad St, Columbus, OH 43204-3333 | 2020-01-28 |
| 1942719307 | Jordan Mackenzie Bomprezzi | Nurse Practitioner | 2575 W Broad St, Columbus, OH 43204-3333 | 2017-09-28 |
| 1376960096 | Buckeye Family Physicians | Clinic/Center | 2575 W Broad St, Columbus, OH 43204-3333 | 2014-03-19 |
| 1780961441 | Maple Leaf Hilltop Pharmacy | Pharmacy | 2575 W Broad St, Columbus, OH 43204-3333 | 2011-11-09 |
| 1033303110 | Bridget Marie Lloyd | Pharmacist | 2575 W Broad St, Columbus, OH 43204-3333 | 2007-08-31 |
| 1669550174 | West Broad Med Phcy Inc | Pharmacy | 2575 W Broad St, Columbus, OH 43204-3333 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215593587 | Raymond Jay Ellis | Technician | 2455 Sullivant Ave, Columbus, OH 43204 | 2019-05-13 |
| 1245791581 | Dedicated Columbus Ohio, LLC | Non-Pharmacy Dispensing Site | 50 North Wilson Road, Columbus, OH 43204 | 2019-03-28 |
| 1770076192 | Morgan Elizabeth Garczyk | Optometrist | 2300 W Broad St Fl 2, Columbus, OH 43204 | 2018-06-11 |
| 1093240731 | Jerusha R Mcclendon | Social Worker | 3188 Mary Ave, Columbus, OH 43204 | 2017-05-01 |
| 1790235588 | American Senior Care Center LLC | Home Health | 3105 W Broad Street, Suite 2, Columbus, OH 43204 | 2016-10-05 |
| 1184082083 | Jordan Fontes | Nurse Practitioner | 2800 West Broad St, Columbus, OH 43204 | 2016-02-05 |
| 1073971248 | John R Sadaghiani | Dentist | 45 N. Wilson Rd, Columbus, OH 43204 | 2016-02-03 |
| 1245615806 | Brittany Muse | Occupational Therapist | 3615 Graybeck Drive, Columbus, OH 43204 | 2015-07-24 |
| 1528453842 | Sadaf Khan | Internal Medicine | 50 N Wilson Road, Columbus, OH 43204 | 2015-04-02 |
| 1053722629 | Kristen Basch | Pharmacist | 4248 Ongaro Dr, Columbus, OH 43204 | 2014-05-16 |
| Find all providers in zip 43204 | ||||
| Taxonomy Code | 3336C0004X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Compounding Pharmacy |
| A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner’s Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. |
| Notes: Sources: NABP Model Practice Act, Appendix C - Good Compounding Practice, USP <795> and <797>, and Pharmacy Compounding Accreditation Board [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437705068 | Goodmed Pharmacy, LLC | Pharmacy | 3433 Agler Rd Ste 1400, Columbus, OH 43219-3388 | 2019-08-09 |
| 1639560139 | Infinity Pharmacy, LLC | Pharmacy | 2773 Cleveland Ave, Columbus, OH 43224-4408 | 2015-02-05 |
| 1467781831 | Central Ohio Compounding Pharmacy | Pharmacy | 7870 Olentangy River Rd Ste 202, Columbus, OH 43235-1300 | 2009-12-15 |
| 1740484179 | Gowyn Inc | Pharmacy | 2051 10th Ave, Columbus, GA 31901-1459 | 2007-06-11 |
| 1386729317 | Slc Holdings | Pharmacy | 2219 5th St N, Columbus, MS 39705-2211 | 2006-10-26 |
| 1518968668 | Drug Store Pharmacy Inc | Pharmacy | 2940 Groveport Rd, Columbus, OH 43207-3255 | 2005-08-10 |
| 1598916801 | Dutch Pharmacies Inc | Pharmacy | 1202 Main St, Columbus, MS 39701-5833 | 2008-10-06 |
| 1861580482 | Avella of Columbus, Inc. | Pharmacy | 4830 Knightsbridge Blvd Ste C, Columbus, OH 43214-2300 | 2006-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548874316 | Harvest Grove Ltc, LLC | Pharmacy | 1113 Medina Rd Ste 700, Medina, OH 44256-9335 | 2020-08-31 |
| 1295286680 | Ksar LLC | Pharmacy | 2245 W Dublin Granville Rd, Suite 103, Worthington, OH 43085-3350 | 2016-10-20 |
| 1386192482 | Mth Enterprises LLC | Pharmacy | 3495 Burnet Ave, Cincinnati, OH 45229-2876 | 2016-09-17 |
| 1679026157 | Lifecare Pharmacy Corp | Pharmacy | 4730 N Summit St, Toledo, OH 43611-2856 | 2016-08-01 |
| 1700251964 | Hux Enterprises | Pharmacy | 641 Hill Rd N Ste B, Pickerington, OH 43147-9346 | 2015-12-14 |
| 1366811630 | Kmg Pharmacy LLC | Pharmacy | 846 E Main St, Trotwood, OH 45426-2911 | 2015-09-17 |
| 1003299918 | Maumee Discount Pharmacy | Pharmacy | 1398 Conant St Ste C, Maumee, OH 43537-1669 | 2015-07-09 |
| 1033532437 | Md Compounding Pharmacy | Pharmacy | 721 Boardman Canfield Rd, Boardman, OH 44512-4386 | 2014-01-22 |
| 1497195895 | Relevant Compounding LLC | Pharmacy | 9329 State Route 220, Waverly, OH 45690-9012 | 2013-06-28 |
| 1679857924 | Health & Wellness Pharmacy LLC | Pharmacy | 5050 Blazer Pkwy Ste 202, Dublin, OH 43017-3376 | 2011-10-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.