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General NPI Number Information
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NPI Number | 1164591764
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Entity Type | Organization
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Legal Business Name | DAYTON OSTEOPATHIC HOSPITAL
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 165 S EDWIN C MOSES BLVD
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City | DAYTON
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State | OH
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Zip | 45402-8472
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Country | US
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Telephone | 937-558-0199
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Fax | 937-558-0198
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Provider Business Mailing Address
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Address Line | 4301 LYONS RD
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City | MIAMISBURG
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State | OH
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Zip | 45342-6446
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Country | US
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Telephone | 937-384-6853
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Fax | 937-384-6804
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | MR. KEVIN BLACKBURN
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Credential | RPH
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Telephone | 937-458-4932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 021374100
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License Number State |
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