Provider Demographics
NPI:1730289687
Name:SOUTHWEST MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:SOUTHWEST MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-467-5948
Mailing Address - Street 1:55 N 200 W STE 1
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-1303
Mailing Address - Country:US
Mailing Address - Phone:435-467-5948
Mailing Address - Fax:435-674-9172
Practice Address - Street 1:55 N 200 W STE 1
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-1303
Practice Address - Country:US
Practice Address - Phone:435-467-5948
Practice Address - Fax:435-674-9172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies