Provider Demographics
NPI:1467700021
Name:CASWELL, GEORDAN NELSON PIKE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GEORDAN
Middle Name:NELSON PIKE
Last Name:CASWELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1771
Mailing Address - Country:US
Mailing Address - Phone:518-483-9090
Mailing Address - Fax:518-483-4186
Practice Address - Street 1:289 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1771
Practice Address - Country:US
Practice Address - Phone:518-483-9090
Practice Address - Fax:518-483-4186
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist