Basic Information
| Provider Information | |||||||||
| NPI: | 1073912820 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SWAFFORD | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | |||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9990 PAGANICA CT | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675028306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206633375 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 206 W 5TH AVE | ||||||||
| Address2: | |||||||||
| City: | HUTCHINSON | ||||||||
| State: | KS | ||||||||
| PostalCode: | 675014807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6206633375 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2014 | ||||||||
| LastUpdateDate: | 08/18/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 9821 | KS | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.