Healthcare Provider Details

I. General information

NPI: 1366604845
Provider Name (Legal Business Name): SWAIM SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5027 NICHOLS DR
FLOWERY BRANCH GA
30542-3714
US

IV. Provider business mailing address

PO BOX 7262
CHESTNUT MOUNTAIN GA
30502-0262
US

V. Phone/Fax

Practice location:
  • Phone: 678-546-9650
  • Fax:
Mailing address:
  • Phone: 678-546-9650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number24326
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number24326
License Number StateGA

VIII. Authorized Official

Name: MR. JEFF SWAIM
Title or Position: PRESIDENT
Credential:
Phone: 678-546-9650