KETTERING MEDICAL CENTER (NPI# 1871667253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871667253 |
| Entity Type | Organization |
| Organization Name | KETTERING MEDICAL CENTER |
| Other Organization Name | KHN PHARMACY KETTERING |
| Practice Address |
3535 Southern Blvd Kettering OH 45429-1221 |
| Mailing Address |
4301 Lyons Rd Miamisburg OH 45342-6446 |
| Practice Telephone | 9373958171 |
| Practice Fax Number | 9373958382 |
| Mailing Telephone | 9374584932 |
| Mailing Fax Number | 9375227198 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-01-09 |
| 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 | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
02051850 | OH | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0678995 | 05 |
| Other Name | Type Code |
|---|---|
| KHN PHARMACY KETTERING | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629511688 | Kettering Medical Center | Pharmacy | 3700 Southern Blvd Ste 105, Kettering, OH 45429-1226 | 2016-11-23 |
| 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 |
| 1336257872 | Kettering Medical Center | Home Health | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2006-08-25 |
| Street Address |
3535 SOUTHERN BLVD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124183 | David M Brouhard | Anesthesiology | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2005-06-16 |
| 1245846757 | Rachel Henderson | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-09-21 |
| 1235745043 | Nipa Mukesh Patel | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1298 | 2020-09-17 |
| 1104437425 | Stephanie Elizabeth Nicholls | Hospitalist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-08-11 |
| 1346865144 | Anesthesia Pearls, LLC | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1568087351 | Pearl Lee | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1922631761 | Michael Patrick Lorey | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-02-20 |
| 1801446315 | Madison A Tate | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-09-17 |
| 1962058966 | Joshua Caleb Courlas | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-15 |
| 1134775273 | Jason Raymond Leigh | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-14 |
| Find all providers in the same location | ||||
| 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 | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1699278325 | Marc Glassman Inc | Pharmacy | 2100 E Whipp Rd, Kettering, OH 45440-2819 | 2018-03-08 |
| 1538409545 | Wellness 1 Pharmacy,llc | Pharmacy | 2420 S Smithville Rd, Kettering, OH 45420-1458 | 2013-02-27 |
| 1831292671 | Ohio Cvs Stores LLC | Pharmacy | 1785 Woodman Dr, Kettering, OH 45420-3661 | 2006-09-07 |
| 1306949755 | Ohio Cvs Stores LLC | Pharmacy | 1410 E Dorothy Ln, Kettering, OH 45429-3806 | 2006-09-07 |
| 1427065432 | Walgreen Co | Pharmacy | 2140 E Dorothy Ln, Kettering, OH 45420-1114 | 2006-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295335024 | Hux Enterprises | Pharmacy | 641 Hill Rd N Ste C, Pickerington, OH 43147-9346 | 2020-10-30 |
| 1891302626 | Uc Healthcare System | Pharmacy | 222 Piedmont Ave Ste 2000, Cincinnati, OH 45219-4231 | 2020-09-25 |
| 1619580966 | Lcrg Bros LLC | Pharmacy | 7584 E Main St, Reynoldsburg, OH 43068-1208 | 2020-08-26 |
| 1528686763 | Lorain Chemists Inc | Pharmacy | 3815 Lorain Ave, Cleveland, OH 44113-3710 | 2020-07-13 |
| 1699397646 | D & G Partners LLC | Pharmacy | 7623 E Main St, Reynoldsburg, OH 43068-1209 | 2020-05-13 |
| 1992325567 | The Kroger Co | Pharmacy | 3255 Eden Ave, Suite 336, Cincinnati, OH 45229 | 2020-04-23 |
| 1689200461 | Cross Point Pharmacy | Pharmacy | 800 Cross Pointe Rd Ste P, Gahanna, OH 43230-6690 | 2020-03-12 |
| 1245870864 | Bravo Rx Pharmacy | Pharmacy | 4125 W Broad St # B, Columbus, OH 43228-1600 | 2020-01-11 |
| 1235777350 | Tan Thai Inc | Pharmacy | 4300 Clime Rd Ste 111, Columbus, OH 43228-6491 | 2019-12-19 |
| 1144868597 | Blanchard Valley Regional Health Center | Pharmacy | 930 Sheriden Dr Ste C, Carey, OH 43316-1502 | 2019-12-17 |
| 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.