Healthcare Provider Details

I. General information

NPI: 1689702599
Provider Name (Legal Business Name): SOUTHWEST MEDICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 CAMINO BLANCO
LAS CRUCES NM
88007-4969
US

IV. Provider business mailing address

PO BOX 338
FAIRACRES NM
88033
US

V. Phone/Fax

Practice location:
  • Phone: 575-524-2400
  • Fax: 575-524-1213
Mailing address:
  • Phone: 575-524-2400
  • Fax: 575-524-1213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number6065
License Number StateNM

VIII. Authorized Official

Name: MS. SHELBA ARLENE STANLEY
Title or Position: CEO/PRESIDENT
Credential:
Phone: 575-524-2400