Healthcare Provider Details

I. General information

NPI: 1174731392
Provider Name (Legal Business Name): BARBARA ANN SWANSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 WOODBURY AVE
NEWINGTON NH
03801-2817
US

IV. Provider business mailing address

534 SALEM ST
WAKEFIELD MA
01880-1214
US

V. Phone/Fax

Practice location:
  • Phone: 603-430-4427
  • Fax:
Mailing address:
  • Phone: 781-245-1176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR1798
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: