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General NPI Number Information
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NPI Number | 1619015674
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Entity Type | Organization
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Legal Business Name | SBW PHARMACY, INC.
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 3676 N HERMITAGE RD STE 6
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City | TRANSFER
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State | PA
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Zip | 16154-1852
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Country | US
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Telephone | 724-646-1131
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Fax | 724-646-1177
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Provider Business Mailing Address
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Address Line | PO BOX 103
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City | TRANSFER
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State | PA
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Zip | 16154-0103
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Country | US
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Telephone | 724-646-1131
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Fax | 724-646-1177
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRETTON CLARK WALBERG
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Credential | RPH
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Telephone | 724-612-2131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PP412067L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP412067L
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License Number State | PA
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