Healthcare Provider Details

I. General information

NPI: 1538052261
Provider Name (Legal Business Name): SWIFT MEDPRO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 W END CT
HALETHORPE MD
21227-4200
US

IV. Provider business mailing address

7310 RITCHIE HWY STE 200
GLEN BURNIE MD
21061-3129
US

V. Phone/Fax

Practice location:
  • Phone: 443-900-0870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: GRACE WAINAINA
Title or Position: DIRECTOR
Credential:
Phone: 443-900-0870