Healthcare Provider Details

I. General information

NPI: 1720968423
Provider Name (Legal Business Name): AUTHORIZED PULMONARY TESTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ALAMEDA RD NW
ALBUQUERQUE NM
87114-2228
US

IV. Provider business mailing address

PO BOX 10295
ALBUQUERQUE NM
87184-0295
US

V. Phone/Fax

Practice location:
  • Phone: 505-269-8363
  • Fax:
Mailing address:
  • Phone: 505-269-8363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name: AMY J SWAPP
Title or Position: MEMBER
Credential:
Phone: 505-269-7882