Provider Demographics
NPI:1376325415
Name:SWING CARE PROVIDER GROUP, P.C.
Entity Type:Organization
Organization Name:SWING CARE PROVIDER GROUP, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-602-0855
Mailing Address - Street 1:440 N BARRANCA AVE # 1801
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1722
Mailing Address - Country:US
Mailing Address - Phone:800-924-7811
Mailing Address - Fax:877-349-1868
Practice Address - Street 1:21 E STATE ST STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-0109
Practice Address - Country:US
Practice Address - Phone:262-667-7326
Practice Address - Fax:877-349-1868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-13
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center