Provider Demographics
NPI:1811583644
Name:SCHWAB, NATHAN GLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:GLEN
Last Name:SCHWAB
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 1:1971 TENNESSEE AVE N
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:TN
Mailing Address - Zip Code:38363-5049
Mailing Address - Country:US
Mailing Address - Phone:219-241-6405
Mailing Address - Fax:
Practice Address - Street 1:1971 TENNESSEE AVE N
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-5049
Practice Address - Country:US
Practice Address - Phone:219-241-6405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPH2455183500000X
IN26022594A183500000X
TN0000042704183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist