MEDICARE: SARA SWANN HCP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	941	WV

General Provider Information

NPI Number	:	1184029449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA SWANN HCP

Provider Business Mailing Address
First Line	:	1526 KANAWHA BLVD W
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25387-2533
Country	:	US
Telephone Number	:	304-342-3300
Fax Number	:	513-332-9248

Provider Business Practice Location Address
First Line	:	1526 KANAWHA BLVD W
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25387-2533
Country	:	US
Telephone Number	:	304-342-3300
Fax Number	:	513-332-9248

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2014
Last Update Date	:	03/25/2015

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Directions to “ SARA SWANN HCP” Practice Location

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