Provider Demographics
NPI:1437269727
Name:SWOPE, ERIC ALAN
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:ALAN
Last Name:SWOPE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17575 SYCAMORE RD
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:OH
Mailing Address - Zip Code:43522-9490
Mailing Address - Country:US
Mailing Address - Phone:419-832-5409
Mailing Address - Fax:
Practice Address - Street 1:24187 FRONT ST
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:OH
Practice Address - Zip Code:43522-9410
Practice Address - Country:US
Practice Address - Phone:419-832-4615
Practice Address - Fax:419-832-0601
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-22520183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist