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General NPI Number Information
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NPI Number | 1831529353
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Entity Type | Organization
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Legal Business Name | BRUNSWIG PHARMACY, PA
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 105 E. PEARL
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City | DIGHTON
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State | KS
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Zip | 67839
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Country | US
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Telephone | 620-397-5778
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Fax | 620-397-2990
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Provider Business Mailing Address
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Address Line | PO BOX 607
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City | DIGHTON
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State | KS
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Zip | 67839-0607
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Country | US
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Telephone | 620-397-5778
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Fax | 620-397-2990
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Authorized Official
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Title or Position | OWNER
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Name | JONATHAN BRUNSWIG
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Credential |
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Telephone | 620-397-5778
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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 | 115839
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License Number State | KS
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