Healthcare Provider Details

I. General information

NPI: 1407781024
Provider Name (Legal Business Name): SWANREE MEDICAL EQUIPMENT AND SUPPLIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 SADDLE CT
FLORENCE SC
29505-5246
US

IV. Provider business mailing address

204 SADDLE CT
FLORENCE SC
29505-5246
US

V. Phone/Fax

Practice location:
  • Phone: 973-626-6548
  • Fax:
Mailing address:
  • Phone: 973-626-6548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. KAITY SHAREE WASHINGTON
Title or Position: ADMINISTRATOR
Credential:
Phone: 973-626-6548