Provider Demographics
NPI:1588072052
Name:SWAFFORD, KIM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KIM
Middle Name:
Last Name:SWAFFORD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9990 PAGANICA CT
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-8306
Mailing Address - Country:US
Mailing Address - Phone:620-921-5871
Mailing Address - Fax:
Practice Address - Street 1:1791 E 23RD
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502
Practice Address - Country:US
Practice Address - Phone:620-665-2101
Practice Address - Fax:620-665-2585
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-09851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist