Healthcare Provider Details

I. General information

NPI: 1962497453
Provider Name (Legal Business Name): SWIFT'S CHILDREN'S CRITICAL CARE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 07/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MILL ST
RENO NV
89502-1576
US

IV. Provider business mailing address

3006 S MARYLAND PKWY #505
LAS VEGAS NV
89109-2218
US

V. Phone/Fax

Practice location:
  • Phone: 888-350-2911
  • Fax: 702-369-5827
Mailing address:
  • Phone: 888-350-2911
  • Fax: 702-369-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES D SWIFT
Title or Position: OWNER / DIRECTOR
Credential: MD
Phone: 888-350-2911