San Juan Dialysis

LBN: Trc - Four Corners Dialysis Clinics Llc
San Juan Dialysis is an health care organization with primary practice located at 4525 Rowe Ave , Farmington NM 87402-3013. The organization recently has only one registered license in Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment, which is considered as the primary health care specialty. Trc - Four Corners Dialysis Clinics Llc can be contacted via phone (505) 326-9102, or through Wey, Samuel via phone (615) 341-6641.

Contact Information

Primary practice address
4525 Rowe Ave Farmington NM 87402-3013
Phone: (505) 326-9102
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel
Phone: (615) 341-6641

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / End-Stage Renal Disease (ESRD) Treatment 261QE0700X

Profile Details

NPI number 1306499405
LBN Legal business name Trc - Four Corners Dialysis Clinics Llc
DBA Doing business as San Juan Dialysis
Authorized official Wey, Samuel
Entity Organization
Organization subpart 1 No
Enumeration date Jul 18th, 2019
Last updated Oct 26th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306499405 NPPES
Texas MEDICAID 23671866

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