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NPI Code Detail

MEDICARE: SANDRA LOVE SWARINGEN O.D.

MEDICARE:   SANDRA LOVE SWARINGEN  O.D.
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
1152W00000XOptometrist1062NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
109882OTHERNCBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3Y1388OTHERNCSERVICES FOR THE BLIND

General Provider Information

NPI Number : 1396841813
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA LOVE SWARINGEN O.D.
Provider Business Mailing Address
First Line : 48 BOONE TRL
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3515
Country : US
Telephone Number : 336-667-3288
Fax Number : 336-838-1092
Provider Business Practice Location Address
First Line : 48 BOONE TRL
Second Line :
City : NORTH WILKESBORO
State : NC
Zip : 28659-3515
Country : US
Telephone Number : 336-667-3288
Fax Number : 336-838-1092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2006
Last Update Date : 07/08/2007

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Directions to “ SANDRA LOVE SWARINGEN O.D.” Practice Location

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