Healthcare Provider Details

I. General information

NPI: 1447633540
Provider Name (Legal Business Name): SOUTHWEST C A R E CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2015
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S RICHARDSON AVE
ROSWELL NM
88203-5577
US

IV. Provider business mailing address

649 HARKLE RD SUITE E
SANTA FE NM
87505-4765
US

V. Phone/Fax

Practice location:
  • Phone: 575-623-1995
  • Fax: 575-623-1998
Mailing address:
  • Phone: 505-989-8200
  • Fax: 505-989-8131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTINE DRUMMOND
Title or Position: CEO
Credential: DDS
Phone: 505-216-0333