Provider Demographics
NPI:1700578143
Name:SW PHARMACY INC
Entity Type:Organization
Organization Name:SW PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:M
Authorized Official - Last Name:JARECHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-769-5104
Mailing Address - Street 1:PO BOX 600873
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32260-0873
Mailing Address - Country:US
Mailing Address - Phone:214-274-4277
Mailing Address - Fax:
Practice Address - Street 1:1233 LANE AVE S STE 9
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32205-6254
Practice Address - Country:US
Practice Address - Phone:904-769-5104
Practice Address - Fax:904-789-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-24
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy