Provider Demographics
NPI:1356460943
Name:SWC CORPORATION
Entity Type:Organization
Organization Name:SWC CORPORATION
Other - Org Name:SWC PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEPKO
Authorized Official - Suffix:JR
Authorized Official - Credentials:RPH, MHA
Authorized Official - Phone:203-852-2687
Mailing Address - Street 1:24 STEVENS ST
Mailing Address - Street 2:MAIN LOBBY
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-3852
Mailing Address - Country:US
Mailing Address - Phone:203-852-2690
Mailing Address - Fax:203-852-2691
Practice Address - Street 1:24 STEVENS ST
Practice Address - Street 2:MAIN LOBBY
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-3852
Practice Address - Country:US
Practice Address - Phone:203-852-2690
Practice Address - Fax:203-852-2691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004182581Medicaid
CT004173217Medicaid
CT004173217Medicaid
1184030001Medicare NSC