Provider Demographics
NPI:1184177727
Name:SWARINGEN, CHARLIE
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:
Last Name:SWARINGEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 CARTER DR
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-9647
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:921 ADELAIDE ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-5056
Practice Address - Country:US
Practice Address - Phone:704-792-6009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No171WV0202XOther Service ProvidersContractorVehicle Modifications
No171WH0202XOther Service ProvidersContractorHome Modifications
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No246YR1600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationRegistered Record Administrator
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care