Provider Demographics
NPI:1174170930
Name:SWIFT NON EMERGENCY MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:SWIFT NON EMERGENCY MEDICAL TRANSPORTATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TRANSPORTATION DRIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-202-4865
Mailing Address - Street 1:8561 MILSAP CT
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-1269
Mailing Address - Country:US
Mailing Address - Phone:916-202-4865
Mailing Address - Fax:
Practice Address - Street 1:8561 MILSAP CT
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-1269
Practice Address - Country:US
Practice Address - Phone:916-202-4865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)