Active NPI
Matt Swan
- Pharmacist
- Wadley, GA
National Provider Identifier
1255098398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 32298
- Practice address
- 48 S Main St
Wadley, GA 30477-3713 - Phone
- (478) 252-5252
- NPI assigned
- Nov 23, 2021
- Last updated
- Nov 23, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 32298 | GA | Primary |
Addresses
Primary practice location
48 S Main St
Wadley, GA 30477-3713
Mailing address
PO Box 69
Wadley, GA 30477-0069
Phone (478) 252-5252
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32298 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swan Pharmacy Inc | Current | Accepting new patients | |
| Swan Pharmacy Inc | Current | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Retail Pharmacy
- Mitchell, GA
- NPI 1295566214
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637625600000",
"number": "1255098398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 69",
"city": "WADLEY",
"state": "GA",
"postal_code": "304770069",
"telephone_number": "478-252-5252"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 S MAIN ST",
"city": "WADLEY",
"state": "GA",
"postal_code": "304773713",
"telephone_number": "478-252-5252"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWAN",
"first_name": "MATT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-11-23",
"last_updated": "2021-11-23",
"certification_date": "2021-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "32298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wadley, GA
- John David Gunn, R.PH.
- Hospital Authority of Jefferson County and the City of Louisville (Physicians Health Group Wadley)
- Danna Sanchez
- Bernice Scales, DDS
- Swan Pharmacy Inc (Gunn Drug Company)
- Rickea Chante Tarver
- Vero Health I, LLC (Vero Health and Rehab of Wadley)
- Wadley SNF Operator LLC (Comfort Creek Nursing and Rehabilitation Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.