# MIAMI VALLEY MEDICAL SUPPLIES INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CENTERVILLE LTC PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326145269
- **Authorized official:** THOMAS MOWBRAY (PRESIDENT)
- **Authorized official phone:** (937) 435-5751

## Contact information

- **Practice address:** 9352 DAYTON LEBANON PIKE STE B, CENTERVILLE, OH 45458-3843
- **Practice address phone:** (937) 435-5751
- **Practice address fax:** (937) 435-5759
- **Mailing address:** 9352 DAYTON LEBANON PIKE STE B, CENTERVILLE, OH 45458-3843
- **Mailing address phone:** (937) 435-5751
- **Mailing address fax:** (937) 435-5759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 021040500 | OH | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 02/03/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2056706 | — | OH |
| 01 | — | 3670761 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |