Provider Demographics
NPI:1407177942
Name:SWIFT MEDICAL SUPPLY
Entity Type:Organization
Organization Name:SWIFT MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRECILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALABBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-514-2599
Mailing Address - Street 1:285 W 6TH ST
Mailing Address - Street 2:209
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-3342
Mailing Address - Country:US
Mailing Address - Phone:310-514-2599
Mailing Address - Fax:
Practice Address - Street 1:285 W 6TH ST
Practice Address - Street 2:209
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3342
Practice Address - Country:US
Practice Address - Phone:310-514-2599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies