Organization
BEAVERCREEK MEDICAL CENTER
Active
Parent organization
BEAVERCREEK MEDICAL CENTER
Other names
Kettering Health Pharmacy Soin
Organization subpart
Yes
Provider details
NPI number
Legal business name
BEAVERCREEK MEDICAL CENTER
Authorized official
MR. KEVIN BLACKBURN RPH (DIRECTOR OF PHARMACY)
(937) 458-4932
Entity
Organization
Contact information
Practice address
3535 PENTAGON BLVD, BEAVERCREEK, OH 45431
(937) 458-4934
(937) 702-4909
Mailing address
4301 LYONS RD, MIAMISBURG, OH 45342-6446
(937) 458-4934
(937) 522-7198
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
022185500
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0065361
—
OH
01
—
3680318
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/02/2012
Last updated
01/27/2025
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