Healthcare Provider Details

I. General information

NPI: 1588072052
Provider Name (Legal Business Name): KIM SWAFFORD PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 E 23RD
HUTCHINSON KS
67502
US

IV. Provider business mailing address

9990 PAGANICA CT
HUTCHINSON KS
67502-8306
US

V. Phone/Fax

Practice location:
  • Phone: 620-665-2101
  • Fax: 620-665-2585
Mailing address:
  • Phone: 620-921-5871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1-09851
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: