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General NPI Number Information
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NPI Number | 1629511688
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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 | 11/23/2016
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Last Update Date | 02/12/2024
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Provider Practice Location Address
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Address Line | 3700 SOUTHERN BLVD STE 105
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City | KETTERING
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State | OH
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Zip | 45429-1226
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Country | US
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Telephone | 937-281-3883
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Fax | 937-281-3879
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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 | 937-458-4934
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Fax | 937-291-3879
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Authorized Official
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Title or Position | ADMIN. ASST. CREDENTIALING
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Name | MRS. LYNDA PATTERSON
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Credential | CPHT
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Telephone | 937-458-4934
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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 |
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License Number State |
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Taxonomy #2
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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 #3
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PMY022662150-03
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License Number State | OH
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