Organization
MADISON MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE MOWRY (CEO)
(760) 795-5440
Entity
Organization
Contact information
Practice address
5651 JEFFERSON ST NE STE A, ALBUQUERQUE, NM 87109-3495
(505) 881-2300
(800) 454-9615
Mailing address
2382 FARADAY AVENUE, SUITE 300, CARLSBAD, CA 92008-7220
(760) 795-5440
(214) 501-0299
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B3396
—
NM
Enumeration date
10/18/2006
Last updated
03/06/2025
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