Healthcare Provider Details

I. General information

NPI: 1295936342
Provider Name (Legal Business Name): HEATHER SWICK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

371 RICHARDSON RD
ASHBY MA
01431
US

IV. Provider business mailing address

371 RICHARDSON RD
ASHBY MA
01431-2007
US

V. Phone/Fax

Practice location:
  • Phone: 978-386-2237
  • Fax:
Mailing address:
  • Phone: 978-386-2237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3140N1450X
TaxonomyPediatric Skilled Nursing Facility
License Number
License Number StateMA

VIII. Authorized Official

Name: MRS. HEATHER ANN SWICK
Title or Position: LPN
Credential:
Phone: 978-386-2237