Healthcare Provider Details

I. General information

NPI: 1982776779
Provider Name (Legal Business Name): DAN EDWARD SWAIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 12/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2279 MAIN ST
MUNHALL PA
15120-2652
US

IV. Provider business mailing address

2279 MAIN ST
MUNHALL PA
15120-2652
US

V. Phone/Fax

Practice location:
  • Phone: 412-461-9800
  • Fax: 412-461-9819
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License NumberPP412939L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPP412939L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPP412939L
License Number StatePA

VIII. Authorized Official

Name: DAN SWAIN
Title or Position: OWNER
Credential:
Phone: 412-461-9800