NPIMap

Organization Active NPI

Wright State University Pharmacy

  • Clinic Pharmacy
  • Dayton, OH
National Provider Identifier
1497829923
Registry record updated Dec 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
020291500 Issued in OH
Legal business name
WRIGHT STATE UNIVERSITY PHARMACY
Practice address
3640 Colonel Glenn Hwy
Dayton, OH 45435-0001
Phone
(937) 775-3414
Fax
(937) 775-2167
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2009

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

Authorized official

Name
John Bale, CPA
Title
Assoc Dean
Phone
(937) 775-3182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 020291500 OH Primary

Addresses

Primary practice location

3640 Colonel Glenn Hwy
Dayton, OH 45435-0001

Mailing address

3817 University Park
Bsom Business Office
Dayton, OH 45435-0001
Phone (937) 775-3414

Other identifiers 2

IdentifierTypeStateIssuer
00581651MedicaidOH
3641138OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • FREDERICK WHITE HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
University Med Serv Ass6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3817 University Park
Dayton, OH 45435

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261180800000",
    "number": "1497829923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3817 UNIVERSITY PARK",
            "address_2": "BSOM BUSINESS OFFICE",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-775-3414",
            "fax_number": "937-775-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 COLONEL GLENN HWY",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454350001",
            "telephone_number": "937-775-3414",
            "fax_number": "937-775-2167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRIGHT STATE UNIVERSITY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-12-19",
        "status": "A",
        "authorized_official_last_name": "BALE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ASSOC DEAN",
        "authorized_official_telephone_number": "937-775-3182",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "OH",
            "license": "020291500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00581651",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "3641138",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FREDERICK WHITE HEALTH CENTER",
            "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 Dec 19, 2009; 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.