NPI 1003517228
904 West Main LLC
Practice location
- Address
- 130 Airport Dr STE B, Farmington, NM 87401-5520
- Phone
- (505) 793-6750
Authorised official
- Name
- Kurt Cook
- Title
- Owner
- Phone
- (505) 793-6750
Registered specialties
Non-emergency Medical Transport (VAN)
Primary
Registry record
- NPI
- 1003517228
- Entity type
- Organization
- NPI issued
- 14 Mar 2023
- Record last updated
- 2 Sep 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.