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General NPI Number Information
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NPI Number | 1205162187
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Entity Type | Individual
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Provider Name | HOLLY M SWINEHART RPH
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Gender | Female
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Dates
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Enumeration Date | 10/27/2009
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Last Update Date | 10/27/2009
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Provider Practice Location Address
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Address Line | 411 MAIN ST
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City | TARKIO
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State | MO
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Zip | 64491-1544
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Country | US
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Telephone | 660-736-5512
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Fax | 660-736-4361
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Provider Business Mailing Address
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Address Line | 27442 280 ST
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City | FAIRFAX
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State | MO
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Zip | 64446-8104
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Country | US
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Telephone | 660-686-2886
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 044524
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License Number State | MO
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