KETTERING MEDICAL CENTER (NPI# 1629511688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629511688 |
| Entity Type | Organization |
| Organization Name | KETTERING MEDICAL CENTER |
| Other Organization Name | KHN SPECIALTY PHARMACY |
| Practice Address |
3700 Southern Blvd Ste 105 Kettering OH 45429-1226 |
| Mailing Address |
4301 Lyons Rd Miamisburg OH 45342-6446 |
| Practice Telephone | 9372813883 |
| Practice Fax Number | 9372813879 |
| Mailing Telephone | 9374584934 |
| Mailing Fax Number | 9372913879 |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2020-02-12 |
| Authorized Official Name | MR. KEVIN BLACKBURN (DIRECTOR OF PHARMACY) |
| Authorized Official Telephone | 9374584932 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | Y |
| Parent Organization Name | KETTERING MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
PMY022662150-03 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0194637 | 05 | |
| PK | 2166255 | 01 |
| Other Name | Type Code |
|---|---|
| KHN Specialty Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790233195 | Kettering Medical Center | General Acute Care Hospital | 524 Grants Trl, Centerville, OH 45459-3120 | 2016-09-14 |
| 1205005063 | Kettering Medical Center | Pharmacy | 4301 Lyons Rd, Miamisburg, OH 45342 | 2008-02-26 |
| 1790859171 | Kettering Medical Center | Pharmacy | 4000 Miamisburg-centerville Rd, Miamisburg, OH 45342 | 2006-11-20 |
| 1396346946 | Kettering Medical Center | Rehabilitation Unit | 4000 Miamisburg Centerville Rd, Miamisburg, OH 45342-7615 | 2020-11-02 |
| 1467090670 | Kettering Medical Center | Clinic/Center | 450b Washington Jackson Rd Ste 104, Eaton, OH 45320-7601 | 2019-12-18 |
| 1023587045 | Kettering Medical Center | General Acute Care Hospital | 600 W Main St, Troy, OH 45373-2928 | 2018-11-20 |
| 1487016796 | Kettering Medical Center | Pharmacy | 825 N Main St, Springboro, OH 45066-2100 | 2016-03-25 |
| 1366508657 | Kettering Medical Center | Clinic/Center | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2006-12-29 |
| 1871667253 | Kettering Medical Center | Pharmacy | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2006-11-20 |
| 1336257872 | Kettering Medical Center | Home Health | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2006-08-25 |
| Street Address |
3700 SOUTHERN BLVD STE 105 |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 3336S0011X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Specialty Pharmacy |
| A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083038368 | Ohio State University Outpatient Pharmacy | Pharmacy | 600 Ackerman Rd, Suite E1014, Columbus, OH 43202-4500 | 2014-02-07 |
| 1669728473 | Pharmacy Specialty Group, LLC | Pharmacy | 6910 Treeline Dr Ste G, Brecksville, OH 44141 | 2012-07-30 |
| 1649507815 | The Cleveland Clinic Foundation | Pharmacy | 3175 Science Park Dr, Ac4b-100, Beachwood, OH 44122-7327 | 2009-11-09 |
| 1801013909 | Rc Compounding Services LLC | Pharmacy | 3030 Center Rd, Poland, OH 44514-2158 | 2007-04-19 |
| 1255471538 | Kids N Kures Pharmacy | Pharmacy | 1419 Boardman Canfield Rd, Boardman, OH 44512-8062 | 2007-02-07 |
| 1649339649 | Ritzman Pharmacies Inc | Pharmacy | 390 Robinson Ave, Suite A, Barberton, OH 44203-3657 | 2006-12-06 |
| 1285703496 | Apria Healthcare, Inc. | Pharmacy | 4060 Technology Dr, Maumee, OH 43537-9263 | 2006-11-06 |
| 1033296363 | Community Care Network Inc | Pharmacy | 3167 Fulton Rd Ste 111, Cleveland, OH 44109-1465 | 2006-11-01 |
| 1750485710 | K-c Health Services Inc | Pharmacy | 4016 Massillon Rd, Ste B, Uniontown, OH 44685-7818 | 2006-09-12 |
| 1760495089 | Southeast Inc | Pharmacy | 131 N High St, Columbus, OH 43215-3018 | 2006-08-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.