NPIMap

Organization Active NPI

Dayton Osteopathic Hospital

Doing business as Kettering Health Pharmacy Washington Township

  • Community/Retail Pharmacy
  • Dayton, OH
National Provider Identifier
1982778361
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
021295500 Issued in NU
Legal business name
DAYTON OSTEOPATHIC HOSPITAL
Doing business as
Kettering Health Pharmacy Washington Township
Practice address
1997 Miamisburg-Centerville Rd
Dayton, OH 45459
Phone
(937) 401-7333
Fax
(937) 401-7334
NPI assigned
Nov 20, 2006
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 021295500 NU Primary

Addresses

Primary practice location

1997 Miamisburg-Centerville Rd
Dayton, OH 45459

Mailing address

4301 Lyons Rd
Miamisburg, OH 45342-6446
Phone (937) 458-4932

Other identifiers 1

IdentifierTypeStateIssuer
2296804MedicaidOH

Other names 1

  • Kettering Health Pharmacy Washington Township Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D0350275Kettering Health Washington Township1997 Miamisburg-Centerville Road, Dayton, OH 45459AccreditationJul 20, 2027
36D2116715Kettering Health Washington Township1997 Miamisburg-Centerville Road, Dayton, OH 45459Certificate of waiverJul 28, 2028

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1982778361",
    "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": "937-458-4932",
            "fax_number": "937-522-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1997 MIAMISBURG-CENTERVILLE RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-401-7333",
            "fax_number": "937-401-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTON OSTEOPATHIC HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAYTON OSTEOPATHIC HOSPITAL",
        "enumeration_date": "2006-11-20",
        "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": "NU",
            "license": "021295500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2296804",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kettering Health Pharmacy Washington Township",
            "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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.