Healthcare Provider Details

I. General information

NPI: 1972881167
Provider Name (Legal Business Name): EDWARD SWINNICH JR. R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2011
Last Update Date: 07/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 ABBOTT RD PHARMACY DEPARTMENT
BUFFALO NY
14220-2039
US

IV. Provider business mailing address

565 ABBOTT RD PHARMACY DEPARTMENT
BUFFALO NY
14220-2039
US

V. Phone/Fax

Practice location:
  • Phone: 716-828-2514
  • Fax: 716-828-2511
Mailing address:
  • Phone: 716-828-2514
  • Fax: 716-828-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: