Healthcare Provider Details

I. General information

NPI: 1427451228
Provider Name (Legal Business Name): SOUTHWEST HORSE POWER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 SIMON LN SW
ALBUQUERQUE NM
87105-5908
US

IV. Provider business mailing address

840 SIMON LN SW
ALBUQUERQUE NM
87105-5908
US

V. Phone/Fax

Practice location:
  • Phone: 505-379-1974
  • Fax: 505-242-4635
Mailing address:
  • Phone: 505-379-1974
  • Fax: 505-242-4635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number StateNM

VIII. Authorized Official

Name: WIN H SIMON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 505-379-1974