Healthcare Provider Details

I. General information

NPI: 1245348788
Provider Name (Legal Business Name): ROBERT FRANCIS KWASNIEWSKI PHARMD, R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 MAIN ST
WEBSTER SD
57274-1305
US

IV. Provider business mailing address

1015 W 7TH ST
WEBSTER SD
57274-1001
US

V. Phone/Fax

Practice location:
  • Phone: 605-345-3351
  • Fax: 605-345-3352
Mailing address:
  • Phone: 605-345-4840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4905
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: