Provider Demographics
NPI:1336284421
Name:S.E.W. ENTERPRISES, INC.
Entity Type:Organization
Organization Name:S.E.W. ENTERPRISES, INC.
Other - Org Name:DUNCAN CLINIC PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYKEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TIDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-247-3725
Mailing Address - Street 1:1111 MEDICAL CENTER CIRCLE
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD
Mailing Address - State:KY
Mailing Address - Zip Code:42066
Mailing Address - Country:US
Mailing Address - Phone:270-247-7000
Mailing Address - Fax:270-247-6033
Practice Address - Street 1:1111 MEDICAL CENTER CIRCLE
Practice Address - Street 2:
Practice Address - City:MAYFIELD
Practice Address - State:KY
Practice Address - Zip Code:42066
Practice Address - Country:US
Practice Address - Phone:270-247-7000
Practice Address - Fax:270-247-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy