Healthcare Provider Details

I. General information

NPI: 1003890880
Provider Name (Legal Business Name): SW MANAGEMENT GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 02/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PELT DR
FAYETTEVILLE NC
28301-3412
US

IV. Provider business mailing address

400 PELT DR
FAYETTEVILLE NC
28301-3412
US

V. Phone/Fax

Practice location:
  • Phone: 910-822-0515
  • Fax: 910-822-0535
Mailing address:
  • Phone: 910-822-0515
  • Fax: 910-822-0535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberNH0577
License Number StateNC

VIII. Authorized Official

Name: MR. JAMES A SCHMIDLIN
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 910-822-0515