Provider Demographics
NPI:1760800619
Name:SWANSON, SVEN (RPH)
Entity type:Individual
Prefix:
First Name:SVEN
Middle Name:
Last Name:SWANSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-3415
Mailing Address - Country:US
Mailing Address - Phone:320-759-1135
Mailing Address - Fax:320-759-1442
Practice Address - Street 1:2612 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-3415
Practice Address - Country:US
Practice Address - Phone:320-759-1135
Practice Address - Fax:320-759-1442
Is Sole Proprietor?:No
Enumeration Date:2014-03-28
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist