MEDICARE: STEVE SWIRSKY

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	332B00000X	Durable Medical Equipment & Medical Supplies	103047	CA

General Provider Information

NPI Number	:	1649364399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVE SWIRSKY

Provider Business Mailing Address
First Line	:	PO BOX 491971
Second Line	:
City	:	REDDING
State	:	CA
Zip	:	96049-1971
Country	:	US
Telephone Number	:	530-243-4155
Fax Number	:

Provider Business Practice Location Address
First Line	:	4103 PEMBROKE LN
Second Line	:
City	:	SHASTA LAKE
State	:	CA
Zip	:	96019-2409
Country	:	US
Telephone Number	:	530-243-4155
Fax Number	:	530-243-4107

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. STEVE SWIRSKY
Credential	:
Telephone Number	:	530-243-4155

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/16/2013

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