Organization
EDGAR SWAN
Active
Other names
GALLATIN OPTICAL COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR EARL SWAN (OPTICIAN)
(615) 452-2111
Entity
Organization
Contact information
Practice address
137 W BROADWAY, GALLATIN, TN 37066-2717
(615) 452-2111
(615) 452-2251
Mailing address
137 W BROADWAY, GALLATIN, TN 37066-2717
(615) 452-2111
(615) 452-2251
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
DPO 657
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0043794
BCBST
TN
05
—
43794
—
TN
Enumeration date
01/17/2008
Last updated
01/17/2008
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