Tuba City Dialysis

LBN: Trc - Four Corners Dialysis Clinics Llc
Tuba City Dialysis is an health care organization with primary practice located at 500 Edgewater Drive , Tuba City AZ 86045-2905. 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 (928) 283-4525, or through Wey, Samuel T via phone (615) 341-6641.

Contact Information

Primary practice address
500 Edgewater Drive Tuba City AZ 86045-2905
Phone: (928) 283-4525
Fax: (928) 283-4801
Website:
Map and Directions
Authorized official contact:
Name: Wey, Samuel T
Phone: (615) 341-6641

Health care specialties

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

Profile Details

NPI number 1083670723
LBN Legal business name Trc - Four Corners Dialysis Clinics Llc
DBA Doing business as Tuba City Dialysis
Authorized official Wey, Samuel T
Entity Organization
Organization subpart 1 No
Enumeration date Apr 21st, 2006
Last updated May 22nd, 2024 - about 2 years ago

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 1083670723 NPPES
Arizona MEDICAID 472663
Arizona MEDICAID 953372911019

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