Provider Demographics
NPI:1497979405
Name:MCSWAIN'S PHARMACY
Entity Type:Organization
Organization Name:MCSWAIN'S PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCSWAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-734-1662
Mailing Address - Street 1:1910 MAIN AVE SW
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-5219
Mailing Address - Country:US
Mailing Address - Phone:256-734-1662
Mailing Address - Fax:256-737-0682
Practice Address - Street 1:1910 MAIN AVE SW
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-5219
Practice Address - Country:US
Practice Address - Phone:256-734-1662
Practice Address - Fax:256-737-0682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL110649332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100002625Medicaid
AL0751980001Medicare ID - Type Unspecified