Provider Demographics
NPI:1013376441
Name:SWANN, HAROLD MICHAEL (RPH)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:MICHAEL
Last Name:SWANN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 HIGHWAY 76
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-9202
Mailing Address - Country:US
Mailing Address - Phone:615-672-7114
Mailing Address - Fax:615-672-7164
Practice Address - Street 1:485 HIGHWAY 76
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9202
Practice Address - Country:US
Practice Address - Phone:615-672-7114
Practice Address - Fax:615-672-7164
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist