MEDICARE: SWL HOMECARE AGENCY

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	261QH0100X	Health Service Clinic/Center
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1528777646
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWL HOMECARE AGENCY

Provider Business Mailing Address
First Line	:	6859 LENOX AVE STE 18
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32205-6149
Country	:	US
Telephone Number	:	800-341-5024
Fax Number	:

Provider Business Practice Location Address
First Line	:	3117 SPRING GLEN RD STE 402
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5906
Country	:	US
Telephone Number	:	800-341-5024
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	MRS. COURTNEY LEWIS
Credential	:	PHLEBOTOMIST
Telephone Number	:	800-341-5024

Provider Enumeration Date	:	11/17/2022
Last Update Date	:	02/08/2023

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Directions to “SWL HOMECARE AGENCY ” Practice Location

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