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904 WEST MAIN LLC
NPI 1235964172
Durable Medical Equipment & Medical Supplies in Farmington, NM

Active since September 02, 2024
615 W BROADWAY, FARMINGTON, NM 87401(505) 535-4196 Get Directions Write a Review

NPPES record last updated: June 12, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About 904 West Main Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

904 WEST MAIN LLC (NPI 1235964172), doing business as Direct Medical Equipment, is a healthcare organization registered as a durable medical equipment & medical supplies in Farmington, New Mexico and active in the NPI registry since September 2024. The organization lists Kurt Cook, Ceo, as its authorized official.

NPPES Registry Identity

NPI1235964172
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business Name904 WEST MAIN LLC
Location Address615 W BROADWAYFarmington, NM 87401-5910
Mailing Address615 W BroadwayFarmington, NM 87401-5910 · (505) 535-4196
Phone(505) 535-4196
Organization SubpartNo
Authorized OfficialKurt CookCeo · (505) 793-6750
Enumeration DateSeptember 2, 2024
Last NPPES UpdateJune 12, 2026
NPPES CertifiedJune 12, 2026
✔ NPI 1235964172 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
615 W BROADWAY, Farmington, NM 87401
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Other Names 1

Doing Business AsDirect Medical Equipment

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 904 West Main LLC's NPI number?

The NPI number for 904 West Main LLC is 1235964172. It was assigned to this organization in the NPPES registry on September 2, 2024. The provider is doing business as Direct Medical Equipment.

Where is 904 West Main LLC located?

904 West Main LLC is located at 615 W Broadway, Farmington, NM 87401. The listed phone number is (505) 535-4196.

What is 904 West Main LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for 904 West Main LLC was last updated on June 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.