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General NPI Number Information
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NPI Number | 1932483963
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Entity Type | Individual
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Provider Name | LARRY G SWOVERLAND RPH
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Gender | Male
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Dates
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Enumeration Date | 10/10/2011
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 1808 ALBANY ST
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City | BEECH GROVE
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State | IN
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Zip | 46107-1404
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Country | US
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Telephone | 317-786-1031
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Fax | 317-786-1036
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Provider Business Mailing Address
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Address Line | 1599 QUAIL GLEN CT
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City | CARMEL
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State | IN
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Zip | 46032-3462
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Country | US
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Telephone | 317-523-7311
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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 | 26011939A
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License Number State | IN
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