NPIMap

Organization Active NPI

Dayton Osteopathic Hospital

Doing business as Kettering Health Pharmacy Preble

  • Community/Retail Pharmacy
  • Eaton, OH
National Provider Identifier
1922266352
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PMY.021801950-03 Issued in OH
Legal business name
DAYTON OSTEOPATHIC HOSPITAL
Doing business as
Kettering Health Pharmacy Preble
Practice address
450B Washington Jackson Rd
Eaton, OH 45320-7600
Phone
(937) 456-8388
Fax
(937) 456-8389
NPI assigned
Jun 2, 2008
Last updated
Jan 22, 2025By the provider in NPPES
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 PMY.021801950-03 OH Primary

Addresses

Primary practice location

450B Washington Jackson Rd
Eaton, OH 45320-7600

Mailing address

4301 Lyons Rd
Miamisburg, OH 45342-6446
Phone (937) 458-4934

Other identifiers 1

IdentifierTypeStateIssuer
2822968MedicaidOH

Other names 1

  • Kettering Health Pharmacy Preble Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dayton Osteopathic Hospital15 organizations share this tax ID, including this one
Part of
Dayton Osteopathic Hospital

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1922266352",
    "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": "450B WASHINGTON JACKSON RD",
            "city": "EATON",
            "state": "OH",
            "postal_code": "453207600",
            "telephone_number": "937-456-8388",
            "fax_number": "937-456-8389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON OSTEOPATHIC HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAYTON OSTEOPATHIC HOSPITAL",
        "enumeration_date": "2008-06-02",
        "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": "OH",
            "license": "PMY.021801950-03",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2822968",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kettering Health Pharmacy Preble",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eaton, 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.