MEDICARE: DAN EDWARD SWAIN RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy		PA

General Provider Information

NPI Number	:	1093951683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAN EDWARD SWAIN RPH

Provider Business Mailing Address
First Line	:	2279 MAIN ST
Second Line	:
City	:	MUNHALL
State	:	PA
Zip	:	15120-2652
Country	:	US
Telephone Number	:	412-461-9800
Fax Number	:	412-461-9819

Provider Business Practice Location Address
First Line	:	2279 MAIN ST
Second Line	:
City	:	MUNHALL
State	:	PA
Zip	:	15120-2652
Country	:	US
Telephone Number	:	412-461-9800
Fax Number	:	412-461-9819

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2009
Last Update Date	:	02/23/2009

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