Provider Demographics
NPI:1295918324
Name:SOUTHWEST FAMILY MEDICAL CARE, INC.
Entity type:Organization
Organization Name:SOUTHWEST FAMILY MEDICAL CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:FLUHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:575-374-2020
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NM
Mailing Address - Zip Code:88415-0157
Mailing Address - Country:US
Mailing Address - Phone:575-374-2020
Mailing Address - Fax:575-374-2040
Practice Address - Street 1:200 COURT ST.
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NM
Practice Address - Zip Code:88415
Practice Address - Country:US
Practice Address - Phone:575-374-2020
Practice Address - Fax:575-374-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2958205261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service