Provider Demographics
NPI:1790931723
Name:SWANTEK, JOSHUA S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:S
Last Name:SWANTEK
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 1:1050 JABARA AVE
Mailing Address - Street 2:SEYMOUR JOHNSON AFB
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27531
Mailing Address - Country:US
Mailing Address - Phone:919-722-1822
Mailing Address - Fax:
Practice Address - Street 1:1050 JABARA AVE
Practice Address - Street 2:SEYMOUR JOHNSON AFB
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27531
Practice Address - Country:US
Practice Address - Phone:919-722-1822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist