MEDICARE: MICHAEL ZWOLINSKI

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	183500000X	Pharmacist	16595	NC

General Provider Information

NPI Number	:	1558669879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL ZWOLINSKI

Provider Business Mailing Address
First Line	:	3314 16TH AVE SE
Second Line	:	SUITE 202 BOX 7
City	:	CONOVER
State	:	NC
Zip	:	28613-9694
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2005 NORTHWEST BLVD
Second Line	:
City	:	NEWTON
State	:	NC
Zip	:	28658-3721
Country	:	US
Telephone Number	:	828-465-1908
Fax Number	:

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

Provider Enumeration Date	:	03/10/2011
Last Update Date	:	03/10/2011

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