Provider Demographics
NPI:1093951683
Name:SWAIN, DAN EDWARD (RPH)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:EDWARD
Last Name:SWAIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2279 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUNHALL
Mailing Address - State:PA
Mailing Address - Zip Code:15120-2652
Mailing Address - Country:US
Mailing Address - Phone:412-461-9800
Mailing Address - Fax:412-461-9819
Practice Address - Street 1:2279 MAIN ST
Practice Address - Street 2:
Practice Address - City:MUNHALL
Practice Address - State:PA
Practice Address - Zip Code:15120-2652
Practice Address - Country:US
Practice Address - Phone:412-461-9800
Practice Address - Fax:412-461-9819
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-02
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA143487Medicare PIN