Healthcare Provider Details

I. General information

NPI: 1659464105
Provider Name (Legal Business Name): SWANSON DRUG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 W.WALNUT ST.
OGDEN IA
50212-0444
US

IV. Provider business mailing address

305 W.WALNUT ST.
OGDEN IA
50212-0444
US

V. Phone/Fax

Practice location:
  • Phone: 515-275-2362
  • Fax: 515-275-4591
Mailing address:
  • Phone: 515-275-2362
  • Fax: 515-275-4591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23
License Number StateIA

VIII. Authorized Official

Name: MS. PATRICIA L. SWANSON
Title or Position: PRESIDENT
Credential:
Phone: 515-275-2362