Mike Swaim & Van Swaim & Bob

Organization Active NPI Community/Retail Pharmacy · Dresden, TN

NPI 1922106962 · NPPES record last updated Jul 14, 2016

Key facts

NPI
1922106962
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
331 (TN)
Legal business name
MIKE SWAIM & VAN SWAIM & BOB
Practice address
8720 Highway 22
Ste a
Dresden, TN 38225-4348
Phone
(731) 364-2207
Fax
(731) 364-2173
NPI assigned
Sep 21, 2006
Organization subpart
No

Authorized official

Name
Robert Daniel, RPH
Title
Owner
Phone
(731) 364-2207

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Bob'S Discount Pharmacy
8720 Highway 22, Dresden, TN 38225-4348 · (731) 364-2207
Nebulizer Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Does not accept assignment
Participating since Mar 23, 1999

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930028326 TN DME Supplier - Pharmacy 1557482056 Practice locations: Dresden, TN

National Provider Directory

Locations

8720 Highway 22
#A
Dresden, TN 38225
Phone (731) 364-2207

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 331 TN Yes

Addresses

Primary practice location

8720 Highway 22
Ste a
Dresden, TN 38225-4348

Mailing address

8720 Highway 22
Ste a
Dresden, TN 38225-4348
Phone (731) 364-2207

Other identifiers

IdentifierTypeStateIssuer
4406030MedicaidTN
2095273OtherPK

Other names

  • BOBS DISCOUNT PHARMACY Doing business as

Other providers in Dresden, TN

All providers in Dresden, TN · Community/Retail Pharmacy in Tennessee

Sources for this page

Verify at the official NPI Registry.