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General NPI Number Information
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NPI Number | 1699820068
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Entity Type | Organization
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Legal Business Name | SOUTHWESTERN HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 408 N AUBURN AVE STE B
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City | FARMINGTON
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State | NM
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Zip | 87401-5816
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Country | US
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Telephone | 505-326-6024
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Fax | 505-327-6923
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Provider Business Mailing Address
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Address Line | 2232 NW 164TH ST
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City | EDMOND
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State | OK
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Zip | 73013-8801
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Country | US
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Telephone | 405-216-3785
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Fax | 405-216-0488
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Authorized Official
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Title or Position | PRESIDENT
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Name | IVY SNIDER
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Credential | RN
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Telephone | 405-216-3785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 6547
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License Number State | NM
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