Organization
SOUTHWEST ENDOSCOPY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA LORANE CARRASCO RN (ADMINISTRATOR)
(505) 999-1610
Entity
Organization
Contact information
Practice address
7788 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4342
(505) 999-1600
(505) 999-1650
Mailing address
7788 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4342
(505) 999-1600
(505) 999-1650
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
6712
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6712
OPERATORS STATE LICENSE
NM
05
—
68469
—
NM
Enumeration date
06/17/2006
Last updated
12/13/2010
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