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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