MEDICARE: ETHAN SCHWARZ R.PH.

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	RP042611L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649389297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ETHAN SCHWARZ R.PH.

Provider Business Mailing Address
First Line	:	PO BOX 123
Second Line	:
City	:	SARVER
State	:	PA
Zip	:	16055-0123
Country	:	US
Telephone Number	:	724-526-3110
Fax Number	:	724-526-3044

Provider Business Practice Location Address
First Line	:	7 WATER ST.
Second Line	:
City	:	EAST BRADY
State	:	PA
Zip	:	16028
Country	:	US
Telephone Number	:	724-526-3110
Fax Number	:	724-526-3044

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	08/26/2022

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