MEDICARE: SEWARD DRUG CO 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
1	3336C0003X	Community/Retail Pharmacy	5301002365	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2308573	OTHER		OTHER ID NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912015371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEWARD DRUG CO INC

Provider Business Mailing Address
First Line	:	43155 W 9 MILE RD
Second Line	:
City	:	NOVI
State	:	MI
Zip	:	48375-4190
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	25190 VAN BORN RD
Second Line	:
City	:	DEARBORN HTS
State	:	MI
Zip	:	48125-2009
Country	:	US
Telephone Number	:	313-292-2520
Fax Number	:	313-292-2675

Authorized Official
Title or Position	:	MANAGER PHARMACY SERVICES
Name	:	STEPHEN GRAHAM
Credential	:
Telephone Number	:	248-348-1570

Provider Enumeration Date	:	08/27/2006
Last Update Date	:	04/15/2008

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Directions to “SEWARD DRUG CO INC ” Practice Location

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