MEDICARE: MS. SUZANNE M SWETT PHARMACIST

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	183500000X	Pharmacist	0000008477	TN

General Provider Information

NPI Number	:	1265744403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUZANNE M SWETT PHARMACIST

Provider Business Mailing Address
First Line	:	2960 CANADA RD
Second Line	:
City	:	LAKELAND
State	:	TN
Zip	:	38002-9712
Country	:	US
Telephone Number	:	901-379-2102
Fax Number	:

Provider Business Practice Location Address
First Line	:	2960 CANADA RD
Second Line	:
City	:	LAKELAND
State	:	TN
Zip	:	38002-9712
Country	:	US
Telephone Number	:	901-379-2102
Fax Number	:

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

Provider Enumeration Date	:	07/03/2010
Last Update Date	:	07/03/2010

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