NPI 1235964172

904 West Main LLC

Organisation Durable Medical Equipment & Medical Supplies Farmington, NM

Practice location

Address: 615 W Broadway, Farmington, NM 87401-5910
Phone: (505) 535-4196

Authorised official

Name: Kurt Cook
Title: Ceo
Phone: (505) 793-6750

Registered specialties

Durable Medical Equipment & Medical Supplies Primary

Suppliers Taxonomy 332B00000X

Other Durable Medical Equipment & Medical Supplies providers in New Mexico →

Registry record

NPI: 1235964172
Entity type: Organization
NPI issued: 2 Sep 2024
Record last updated: 12 Jun 2026

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.