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General NPI Number Information
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NPI Number | 1124273537
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Entity Type | Organization
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Legal Business Name | S & W PHARMACIES, INC
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 220 W PEARL ST APT A
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City | TREMONT
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State | IL
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Zip | 61568-7905
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Country | US
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Telephone | 309-925-2400
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Fax | 309-925-5301
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Provider Business Mailing Address
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Address Line | 220 W PEARL ST APT A
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City | TREMONT
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State | IL
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Zip | 61568-7905
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Country | US
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Telephone | 309-925-2400
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Fax | 309-925-5301
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM J WIEMER
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Credential | PHARMD
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Telephone | 309-925-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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