NPIMap

Organization Active NPI

Dayton Osteopathic Hospital

  • Community/Retail Pharmacy
  • Dayton, OH
National Provider Identifier
1164591764
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021374100
Legal business name
DAYTON OSTEOPATHIC HOSPITAL
Practice address
165 S Edwin C Moses Blvd
Dayton, OH 45402-8472
Phone
(937) 558-0199
Fax
(937) 558-0198
NPI assigned
Nov 7, 2006
Organization subpart
Yes
Parent organization
DAYTON OSTEOPATHIC HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 021374100 Primary

Addresses

Primary practice location

165 S Edwin C Moses Blvd
Dayton, OH 45402-8472

Mailing address

4301 Lyons Rd
Miamisburg, OH 45342-6446
Phone (937) 384-6853

Other identifiers 1

IdentifierTypeStateIssuer
2403670MedicaidOH

Other names 1

  • Kettering Health Pharmacy Cassano Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southview Hospital Pharmacy15 organizations share this tax ID, including this one
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.

View all 14

Locations

4301 Lyons Rd
Miamisburg, OH 45342
Phone (937) 458-4934

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1164591764",
    "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": "937-384-6853",
            "fax_number": "937-384-6804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S EDWIN C MOSES BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454028472",
            "telephone_number": "937-558-0199",
            "fax_number": "937-558-0198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON OSTEOPATHIC HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAYTON OSTEOPATHIC HOSPITAL",
        "enumeration_date": "2006-11-07",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": "021374100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2403670",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kettering Health Pharmacy Cassano",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dayton, 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.

Verify at the official NPI Registry.