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General NPI Number Information
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NPI Number | 1689288391
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Entity Type | Individual
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Provider Name | BRIAN DOUGLAS CASWELL R.PH.
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Gender | Male
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Dates
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Enumeration Date | 09/01/2020
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Last Update Date | 09/01/2020
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Provider Practice Location Address
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Address Line | 1920 MILITARY AVE
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City | BAXTER SPRINGS
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State | KS
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Zip | 66713-2039
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Country | US
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Telephone | 620-856-5555
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Fax | 620-856-3455
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Provider Business Mailing Address
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Address Line | 1920 MILITARY AVE
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City | BAXTER SPRINGS
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State | KS
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Zip | 66713-2039
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Country | US
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Telephone | 620-856-5555
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Fax | 620-856-3455
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2-13206
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License Number State | KS
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