Healthcare Provider Details

I. General information

NPI: 1699758425
Provider Name (Legal Business Name): BRIAN TODD SWARTZ RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 08/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4652 N M 37 HWY
MIDDLEVILLE MI
49333-8806
US

IV. Provider business mailing address

8361 THORNAPPLE RIVER DR SE
CALEDONIA MI
49316-9568
US

V. Phone/Fax

Practice location:
  • Phone: 269-795-7936
  • Fax:
Mailing address:
  • Phone: 616-891-1674
  • Fax: 269-795-4928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302025466
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: