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Individual

KENNETH JAMES SWINARSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD.

Contact information

Practice address
620 W STATE ST, GRAND ISLAND, NE 68801-3552
(308) 384-8228
(308) 384-6835
Mailing address
620 WEST STATE STREET, GTRAND ISLAND, NE 68801
(308) 384-8228
(308) 384-6835

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11616
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0367450002
MEDICARE PTAN
05
40758509202
NE
Enumeration date
04/20/2011
Last updated
04/20/2011
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