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General NPI Number Information
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NPI Number | 1629031760
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Entity Type | Organization
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Legal Business Name | SWIENT, LLC
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 900 N LIBERTY ST SUITE 305
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City | BOISE
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State | ID
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Zip | 83704-8704
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Country | US
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Telephone | 208-367-3320
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Fax |
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Provider Business Mailing Address
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Address Line | 900 N LIBERTY ST SUITE 400
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City | BOISE
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State | ID
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Zip | 83704-8704
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. RYAN PHARIS
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Credential |
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Telephone | 208-367-7423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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