Healthcare Provider Details

I. General information

NPI: 1962510339
Provider Name (Legal Business Name): SWANTON DRUG, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2006
Last Update Date: 04/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 E. AIRPORT HWY
SWANTON OH
43558
US

IV. Provider business mailing address

151 E. AIRPORT HWY
SWANTON OH
43558
US

V. Phone/Fax

Practice location:
  • Phone: 419-825-5050
  • Fax: 419-825-2190
Mailing address:
  • Phone: 419-825-5050
  • Fax: 419-825-2190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number021459200
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: NAJIB MAWAD
Title or Position: OWNER
Credential: R.PH./OWNER
Phone: 419-825-5050