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General NPI Number Information
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NPI Number | 1487108932
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Entity Type | Organization
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Legal Business Name | DAYTON CHILDRENS HOSPITAL
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Dates
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Enumeration Date | 08/12/2016
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 3333 W TECH RD
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City | MIAMISBURG
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State | OH
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Zip | 45342-0955
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Country | US
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Telephone | 937-641-5080
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Fax | 937-641-4848
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Provider Business Mailing Address
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Address Line | 3333 W TECH RD
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City | MIAMISBURG
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State | OH
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Zip | 45342-0955
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Country | US
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Telephone | 937-641-5080
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Fax | 937-641-4848
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Authorized Official
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Title or Position | VP/CFO
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Name | CHRIS BERGMAN
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Credential |
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Telephone | 937-641-5080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | CLPH.020612250-
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License Number State | OH
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