1407953573 NPI number — SWEA, P.C.

Table of content: (NPI 1407953573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407953573 NPI number — SWEA, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWEA, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407953573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 E PIMA ST
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85712-5601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-382-2819
Provider Business Mailing Address Fax Number:
520-382-2832

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5301 E GRANT RD
Provider Second Line Business Practice Location Address:
TMC EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85712-2805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-324-1922
Provider Business Practice Location Address Fax Number:
520-324-1088
Provider Enumeration Date:
09/20/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COMPTON
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
EUGENE
Authorized Official Title or Position:
PRESIDENT AND MEDICAL DIRECTOR
Authorized Official Telephone Number:
520-324-1922

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: AZ0035930 . This is a "BCBS GROUP PIN" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: C12342 . This is a "RAILROAD MEDICARE GROUP #" identifier . This identifiers is of the category "OTHER".
  • Identifier: IZ6811 . This is a "HEALTHNET GROUP #" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".