Healthcare Provider Details

I. General information

NPI: 1659633246
Provider Name (Legal Business Name): PAUL MICHAEL SAWARYNSKI PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2012
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N BEST AVE
WALNUTPORT PA
18088-1208
US

IV. Provider business mailing address

722 STONE HILL DR
WALNUTPORT PA
18088-9590
US

V. Phone/Fax

Practice location:
  • Phone: 610-767-2541
  • Fax: 610-767-2901
Mailing address:
  • Phone: 610-767-6584
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP437767
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPI000553
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: