Provider Demographics
NPI:1003202201
Name:SOUTHWEST DME INC
Entity Type:Organization
Organization Name:SOUTHWEST DME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:CAMERON
Authorized Official - Last Name:PADGETT
Authorized Official - Suffix:
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:505-716-4180
Mailing Address - Street 1:3401 N BUTLER AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-6866
Mailing Address - Country:US
Mailing Address - Phone:505-947-5010
Mailing Address - Fax:
Practice Address - Street 1:3401 N BUTLER AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-6866
Practice Address - Country:US
Practice Address - Phone:505-947-5010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPT2010-0068332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies