Healthcare Provider Details
I. General information
NPI: 1124492731
Provider Name (Legal Business Name): SWANSON ANESTHESIA AND FINANCE CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/19/2015
Last Update Date: 11/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9551 PASEO DEL NORTE NE
ALBUQUERQUE NM
87122-2975
US
IV. Provider business mailing address
1717 VALDEZ DR NE
ALBUQUERQUE NM
87112-4857
US
V. Phone/Fax
- Phone: 505-681-0809
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
SWANSON
Title or Position: PROVIDER
Credential:
Phone: 505-681-0809