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Organization
MIAMI VALLEY MEDICAL SUPPLIES INC.
Active
Organization
MIAMI VALLEY MEDICAL SUPPLIES INC.
Active
Other names
CENTERVILLE LTC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MOWBRAY (PRESIDENT)
(937) 435-5751
Entity
Organization
Contact information
Practice address
9352 DAYTON LEBANON PIKE STE B, CENTERVILLE, OH 45458-3843
(937) 435-5751
(937) 435-5759
Mailing address
9352 DAYTON LEBANON PIKE STE B, CENTERVILLE, OH 45458-3843
(937) 435-5751
(937) 435-5759
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
021040500
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2056706
—
OH
01
—
3670761
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/20/2006
Last updated
02/03/2011
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