Provider Demographics
NPI:1053455774
Name:SWARD-KEMP DRUG CO OF OLIVIA INC
Entity type:Organization
Organization Name:SWARD-KEMP DRUG CO OF OLIVIA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:507-637-2911
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:OLIVIA
Mailing Address - State:MN
Mailing Address - Zip Code:56277
Mailing Address - Country:US
Mailing Address - Phone:320-523-2110
Mailing Address - Fax:320-523-2113
Practice Address - Street 1:801 EAST DEPUE AVENUE
Practice Address - Street 2:
Practice Address - City:OLIVIA
Practice Address - State:MN
Practice Address - Zip Code:56277
Practice Address - Country:US
Practice Address - Phone:320-523-2110
Practice Address - Fax:320-523-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2623433336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN670123000Medicaid
MN47258PAOtherBLUE CROSS BLUE SHIELD
4994470001Medicare NSC