Provider Demographics
NPI:1083059463
Name:SWANSON, WARD LYNN (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:WARD
Middle Name:LYNN
Last Name:SWANSON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6412 S PARKER RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-3011
Mailing Address - Country:US
Mailing Address - Phone:303-627-6111
Mailing Address - Fax:303-627-9475
Practice Address - Street 1:6412 S PARKER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-3011
Practice Address - Country:US
Practice Address - Phone:303-627-6111
Practice Address - Fax:303-627-9475
Is Sole Proprietor?:No
Enumeration Date:2013-04-30
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist