Healthcare Provider Details

I. General information

NPI: 1114211455
Provider Name (Legal Business Name): KELLY MCHAFFIE SWAIN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 BOILING SPRINGS RD
BOILING SPRINGS SC
29316-5716
US

IV. Provider business mailing address

3720 BOILING SPRINGS RD
BOILING SPRINGS SC
29316-5716
US

V. Phone/Fax

Practice location:
  • Phone: 864-814-2388
  • Fax: 864-578-4139
Mailing address:
  • Phone: 864-814-2388
  • Fax: 864-578-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10532
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: