Provider Demographics
NPI: | 1740847201 |
---|---|
Name: | SWIFTCARE FAMILY CLINIC AND WELLNESS INC |
Entity type: | Organization |
Organization Name: | SWIFTCARE FAMILY CLINIC AND WELLNESS INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO/FAMILY NURSE PRACTITIONER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | OLUFUNMILAYO |
Authorized Official - Middle Name: | SAYO |
Authorized Official - Last Name: | ONUOHA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DNP-CRNP |
Authorized Official - Phone: | 301-752-1238 |
Mailing Address - Street 1: | 1841 BRIGHTSEAT RD |
Mailing Address - Street 2: | |
Mailing Address - City: | LANDOVER |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20785-4250 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 301-752-1238 |
Mailing Address - Fax: | 240-691-0279 |
Practice Address - Street 1: | 1841/1843 BRIGHTSEAT ROAD |
Practice Address - Street 2: | |
Practice Address - City: | LANDOVER |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20785-2078 |
Practice Address - Country: | US |
Practice Address - Phone: | 301-752-1238 |
Practice Address - Fax: | 240-691-0279 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2019-05-21 |
Last Update Date: | 2020-04-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |