OrganizationActive
904 West Main LLC
NPI 1235964172 · Durable Medical Equipment & Medical Supplies · Farmington, NM
Provider details
- NPI number
- 1235964172
- Entity type
- Organization
- Primary specialty
- Durable Medical Equipment & Medical SuppliesSuppliers
- Organization subpart
- No
- Authorized official
- Kurt Cook, Ceo(505) 793-6750
Specialties & taxonomies
Suppliers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
615 W Broadway
Farmington, NM 87401-5910
Phone: (505) 535-4196
Street-level locationGet directions
Mailing address
615 W Broadway
Farmington, NM 87401-5910
Other names (DBA / former)
- Doing business as
- Direct Medical Equipment
Registry dates
- Enumerated
- 2024-09-02
- Last updated
- 2024-09-02
- Certified
- 2024-09-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.