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Organization
KETTERING MEDICAL CENTER
Active
Organization
KETTERING MEDICAL CENTER
Active
Parent organization
KETTERING MEDICAL CENTER
Other names
Kettering Health Pharmacy Main Campus
Organization subpart
Yes
Provider details
NPI number
Legal business name
KETTERING MEDICAL CENTER
Authorized official
MR. KEVIN BLACKBURN RPH (DIRECTOR OF PHARMACY)
(937) 458-4932
Entity
Organization
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8171
(937) 395-8382
Mailing address
4301 LYONS RD, MIAMISBURG, OH 45342-6446
(937) 458-4932
(937) 522-7198
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
02051850
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0678995
—
OH
Enumeration date
11/20/2006
Last updated
01/22/2025
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