Healthcare Provider Details

I. General information

NPI: 1275036170
Provider Name (Legal Business Name): SWC HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2018
Last Update Date: 07/08/2023
Certification Date: 07/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 BALD EAGLE DR
SANTA ROSA BEACH FL
32459-8342
US

IV. Provider business mailing address

10 BALD EAGLE DR
SANTA ROSA BEACH FL
32459-8342
US

V. Phone/Fax

Practice location:
  • Phone: 850-517-0877
  • Fax:
Mailing address:
  • Phone: 850-517-0877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number9317115
License Number StateFL

VIII. Authorized Official

Name: SUZANNE MOREE
Title or Position: OWNER/AUTHORIZED OFFICIAL
Credential: APRN-FNP
Phone: 850-517-0877