Active NPI
Dayton Osteopathic Hospital
- Community/Retail Pharmacy
- Beavercreek, OH
National Provider Identifier
1043225683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- PMY.021561900-03
- Legal business name
- DAYTON OSTEOPATHIC HOSPITAL
- Practice address
- 2510 Commons Blvd
Beavercreek, OH 45431-3820 - Phone
- (937) 558-3030
- Fax
- (937) 558-3089
- NPI assigned
- Jul 30, 2006
- Organization subpart
- Yes
- Parent organization
- DAYTON OSTEOPATHIC HOSPITAL
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kevin Blackburn, RPH
- Title
- Director of Pharmacy
- Phone
- (937) 458-4932
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PMY.021561900-03 | OH | Primary |
Addresses
Primary practice location
2510 Commons Blvd
Beavercreek, OH 45431-3820
Mailing address
4301 Lyons Rd
Miamisburg, OH 45342-6446
Phone (937) 458-4934
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2645043 | Medicaid | OH |
Other names 1
- Kettering Health Pharmacy Beavercreek
National Provider Directory
National Provider Directory- Tax ID family
- Southview Hospital Pharmacy
- Part of
- Southview Hospital Pharmacy
Other organizations with this tax ID 14
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Acute Care Hospital
- Dayton, OH
- NPI 1053339507
-
- Obstetrics & Gynecology Physician
- Dayton, OH
- NPI 1053386102
-
- Community/Retail Pharmacy
- Dayton, OH
- NPI 1164591764
-
- Health Service Clinic/Center
- Dayton, OH
- NPI 1386619245
-
- Medical Specialty Clinic/Center
- Dayton, OH
- NPI 1568633980
-
- Multi-Specialty Clinic/Center
- Dayton, OH
- NPI 1588630347
-
- Community/Retail Pharmacy
- Huber Heights, OH
- NPI 1609940089
-
- Specialty Pharmacy
- Kettering, OH
- NPI 1629511688
-
- Health Service Clinic/Center
- Dayton, OH
- NPI 1679548739
-
- Community/Retail Pharmacy
- Dayton, OH
- NPI 1811072010
-
- Community/Retail Pharmacy
- Eaton, OH
- NPI 1922266352
-
- Community/Retail Pharmacy
- Dayton, OH
- NPI 1982778361
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1737504000000",
"number": "1043225683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 LYONS RD",
"city": "MIAMISBURG",
"state": "OH",
"postal_code": "453426446",
"telephone_number": "937-458-4934",
"fax_number": "937-522-7198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2510 COMMONS BLVD",
"city": "BEAVERCREEK",
"state": "OH",
"postal_code": "454313820",
"telephone_number": "937-558-3030",
"fax_number": "937-558-3089"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAYTON OSTEOPATHIC HOSPITAL",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DAYTON OSTEOPATHIC HOSPITAL",
"enumeration_date": "2006-07-30",
"last_updated": "2025-01-22",
"certification_date": "2025-01-22",
"status": "A",
"authorized_official_last_name": "BLACKBURN",
"authorized_official_first_name": "KEVIN",
"authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
"authorized_official_telephone_number": "937-458-4932",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "OH",
"license": "PMY.021561900-03",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2645043",
"state": "OH"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kettering Health Pharmacy Beavercreek",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Beavercreek, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.