MEDICARE: SWING CARE PROVIDER GROUP, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1245012384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWING CARE PROVIDER GROUP, P.C.

Provider Business Mailing Address
First Line	:	440 N BARRANCA AVE # 1801
Second Line	:
City	:	COVINA
State	:	CA
Zip	:	91723-1722
Country	:	US
Telephone Number	:	800-924-7811
Fax Number	:	877-349-1868

Provider Business Practice Location Address
First Line	:	4000 FABER PLACE DR STE 300
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8587
Country	:	US
Telephone Number	:	262-667-7326
Fax Number	:	877-349-1868

Authorized Official
Title or Position	:	HEAD OF OPERATIONS
Name	:	JEREMY FRANK
Credential	:
Telephone Number	:	415-602-0855

Provider Enumeration Date	:	10/13/2023
Last Update Date	:	12/05/2025

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