Healthcare Provider Details

I. General information

NPI: 1992835037
Provider Name (Legal Business Name): JARRETT SWAFFORD PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14821 DAYTON PIKE STE 115
SALE CREEK TN
37373-5752
US

IV. Provider business mailing address

PO BOX 646
SALE CREEK TN
37373-0646
US

V. Phone/Fax

Practice location:
  • Phone: 423-486-9404
  • Fax: 423-486-9434
Mailing address:
  • Phone: 423-486-9404
  • Fax: 423-486-9434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number23990
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: