Provider Demographics
NPI:1356484513
Name:SWARD-KEMP DRUG CO INC
Entity Type:Organization
Organization Name:SWARD-KEMP DRUG CO INC
Other - Org Name:SWARD KEMP SNYDER DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:507-637-2911
Mailing Address - Street 1:PO BOX 419
Mailing Address - Street 2:
Mailing Address - City:REDWOOD FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56283
Mailing Address - Country:US
Mailing Address - Phone:507-637-2911
Mailing Address - Fax:507-637-5869
Practice Address - Street 1:207 SOUTH WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:REDWOOD FALLS
Practice Address - State:MN
Practice Address - Zip Code:56283
Practice Address - Country:US
Practice Address - Phone:507-637-2911
Practice Address - Fax:507-637-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2050423336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN902257100Medicaid
MN11G23SWOtherBLUE CROSS BLUE SHIELD
MN47283SWOtherBLUE CROSS BLUE SHIELD
MN11G23SWOtherBLUE CROSS BLUE SHIELD