Organization
STARGATE MOBILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFERIE A DODGE (OWNER)
(575) 208-0056
Entity
Organization
Contact information
Practice address
500 S SUNSET AVE, ROSWELL, NM 88203-2866
(575) 208-0056
(505) 216-9380
Mailing address
500 S SUNSET AVE, ROSWELL, NM 88203-2866
(575) 208-0056
(505) 216-9380
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
03065376002
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42874360
—
NM
Enumeration date
08/19/2006
Last updated
12/24/2007
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