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NPI Code Detail

MEDICARE: SBW PHARMACY, INC.

MEDICARE: SBW PHARMACY, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesPP412067LPA
23336C0003XCommunity/Retail PharmacyPP412067LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619015674
Entity Type Code : Organization
Provider Name (Legal Business Name) : SBW PHARMACY, INC.
Provider Business Mailing Address
First Line : PO BOX 103
Second Line :
City : TRANSFER
State : PA
Zip : 16154-0103
Country : US
Telephone Number : 724-646-1131
Fax Number : 724-646-1177
Provider Business Practice Location Address
First Line : 3676 N HERMITAGE RD STE 6
Second Line :
City : TRANSFER
State : PA
Zip : 16154-1852
Country : US
Telephone Number : 724-646-1131
Fax Number : 724-646-1177
Authorized Official
Title or Position : PRESIDENT
Name : MR. BRETTON CLARK WALBERG
Credential : RPH
Telephone Number : 724-612-2131
Provider Enumeration Date : 02/02/2007
Last Update Date : 02/06/2024

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