MEDICARE: DAN EDWARD SWAIN

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	3336L0003X	Long Term Care Pharmacy	PP412939L	PA
2	333600000X	Pharmacy	PP412939L	PA
3	3336C0003X	Community/Retail Pharmacy	PP412939L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3944685	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1982776779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAN EDWARD SWAIN

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

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	:	OWNER
Name	:	DAN SWAIN
Credential	:
Telephone Number	:	412-461-9800

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	12/24/2008

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Directions to “DAN EDWARD SWAIN ” Practice Location

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