Healthcare Provider Details

I. General information

NPI: 1982209920
Provider Name (Legal Business Name): JOHN W SWANN PD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 TRUMAN AVE
KEY WEST FL
33040-3141
US

IV. Provider business mailing address

530 TRUMAN AVE
KEY WEST FL
33040-3141
US

V. Phone/Fax

Practice location:
  • Phone: 305-294-2576
  • Fax: 305-294-4843
Mailing address:
  • Phone: 305-294-2576
  • Fax: 305-294-4843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS53209
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: