Healthcare Provider Details

I. General information

NPI: 1093598898
Provider Name (Legal Business Name): CS PACS 3 NORTHEAST, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2023
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 NORTH PL
FREDERICK MD
21701-6200
US

IV. Provider business mailing address

1643 NW 136TH AVE STE 100
SUNRISE FL
33323-2857
US

V. Phone/Fax

Practice location:
  • Phone: 301-695-6618
  • Fax:
Mailing address:
  • Phone: 865-500-1325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DARREN SWENSON
Title or Position: PRESIDENT
Credential: MD
Phone: 865-693-1000