Healthcare Provider Details

I. General information

NPI: 1215654355
Provider Name (Legal Business Name): SWIFT CARE TRANSPORT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 AZTECA DR
MATTHEWS NC
28104-4961
US

IV. Provider business mailing address

112 AZTECA DR
MATTHEWS NC
28104-4961
US

V. Phone/Fax

Practice location:
  • Phone: 407-970-3009
  • Fax:
Mailing address:
  • Phone: 407-970-3009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. OTTMAN DAHER
Title or Position: OWNER
Credential:
Phone: 407-970-3009