MEDICARE: DAYTON OSTEOPATHIC HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	021382950

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609940089
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAYTON OSTEOPATHIC HOSPITAL

Provider Business Mailing Address
First Line	:	4301 LYONS RD
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-6446
Country	:	US
Telephone Number	:	937-458-4934
Fax Number	:	937-522-7198

Provider Business Practice Location Address
First Line	:	8701 TROY PIKE
Second Line	:
City	:	HUBER HEIGHTS
State	:	OH
Zip	:	45424-1066
Country	:	US
Telephone Number	:	937-585-3333
Fax Number	:	937-558-3331

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	MR. KEVIN BLACKBURN
Credential	:	RPH
Telephone Number	:	937-458-4932

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	01/22/2025

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Directions to “DAYTON OSTEOPATHIC HOSPITAL ” Practice Location

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