TRC - FOUR CORNERS DIALYSIS CLINICS LLC (NPI# 1700842432) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700842432 |
| Entity Type | Organization |
| Organization Name | TRC - FOUR CORNERS DIALYSIS CLINICS LLC |
| Other Organization Name | HOPI DIALYSIS CENTER |
| Practice Address |
Hwy 264 Mile Marker 388 Polacca AZ 86042-0964 |
| Mailing Address |
5200 Virginia Way L&c Dept Brentwood TN 37027-7569 |
| Practice Telephone | 9287375490 |
| Practice Fax Number | 9287375497 |
| Mailing Telephone | 6153416814 |
| Mailing Fax Number | 8778507073 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2019-11-18 |
| Authorized Official Name | JAMES K HILGER (CHIEF ACCOUNTING OFFICER) |
| Authorized Official Telephone | 2537334500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QE0700X |
Clinic/Center Specialization: End-Stage Renal Disease (ESRD) Treatment |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 631152 | 05 |
| Other Name | Type Code |
|---|---|
| Hopi Dialysis Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184680803 | Trc - Four Corners Dialysis Clinics LLC | Clinic/Center | Us Highway 191, Chinle, AZ 86503 | 2006-04-21 |
| 1063477727 | Trc - Four Corners Dialysis Clinics LLC | Clinic/Center | 801 W Broadway, Farmington, NM 87401-5650 | 2006-04-18 |
| 1487619326 | Trc - Four Corners Dialysis Clinics LLC | Clinic/Center | Us Highway 491 North, Shiprock, NM 87420-2156 | 2006-04-20 |
| Street Address |
HWY 264 MILE MARKER 388 |
| City | POLACCA |
| State | AZ |
| Zip Code | 86042-0964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922455013 | Hopi Health Care Center | General Acute Care Hospital | Hwy 264, Mp 388, Polacca, AZ 86042 | 2016-05-18 |
| 1871620476 | Darlene Kay Greener | Registered Nurse | Hwy 264, Polacca, AZ 86042 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553787 | Megan Gilliam | Pharmacist | Mile Post 288 Hwy 264, Polacca, AZ 86042 | 2020-09-21 |
| 1295348787 | Emma Guadalupe Cortez | Nurse's Aide | Hopi Health Care, Hwy 264 Mp 388, Polacca, AZ 86042 | 2020-08-25 |
| 1942835434 | Kevin C Powers | Registered Nurse | Route 264 Mp 388, Polacca, AZ 86042 | 2020-03-05 |
| 1780217463 | Kim N Le | Family Medicine | Mile Post 388 Highway 264, Polacca, AZ 86042 | 2020-02-20 |
| 1265959365 | Karen Olivia Francis | Registered Nurse | Highway 264 Mile Post, Hopi Health Care Facility, Polacca, AZ 86042 | 2017-08-29 |
| 1629598339 | Marina Kanoelani Mehau-sanchez | Pharmacist | Hwy 264 At Mile Post 388, Hopi Health Care Center, Polacca, AZ 86042 | 2017-06-23 |
| 1184096786 | Erica Lalo | Technician, Other | Hwy 264 Mp388, Polacca, AZ 86042 | 2015-10-22 |
| 1790124618 | Michael Everett Robinson | Registered Nurse | Highway 264 Mile Post 388, Polacca, Az 86042, Hopi Health Care Center (ihs), Polacca, AZ 86042 | 2013-06-25 |
| 1760728232 | Rhanishia Smith | Registered Nurse | Highway 264 Mile Pot 388, Polacca, AZ 86042 | 2013-01-02 |
| 1871818492 | Stacy Talahytewa II | Radiologic Technologist | Hwy 264 Mile Post 388, Polacca, AZ 86042 | 2010-04-07 |
| Find all providers in zip 86042 | ||||
| Taxonomy Code | 261QE0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | End-Stage Renal Disease (ESRD) Treatment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063028124 | Fresenius Medical Care Tuba City, LLC | Clinic/Center | 50 S. Main Street, Ste 108, Tuba City, AZ 86045 | 2020-09-23 |
| 1043826191 | Fresenius Medical Care Yuma, LLC | Clinic/Center | 1200 S Castle Dome Ave Ste C, Yuma, AZ 85365-5305 | 2020-09-23 |
| 1215577598 | Southwest Kidney - Davita Dialysis Partners LLC | Clinic/Center | 14671 W Mountain View Blvd Ste 102, Surprise, AZ 85374-4840 | 2020-01-14 |
| 1225678774 | Endicott Dialysis LLC | Clinic/Center | 2500 S 8th Ave Ste 102, Yuma, AZ 85364-7132 | 2020-01-13 |
| 1811450281 | Bio Medical Applications of Arizona LLC | Clinic/Center | 450 S Gilbert Rd, Chandler, AZ 85225-2479 | 2019-04-11 |
| 1437612165 | Southwest Kidney - Davita Dialysis Partners LLC | Clinic/Center | 14620 W Encanto Blvd Ste 110, Goodyear, AZ 85395-1616 | 2019-04-10 |
| 1649730953 | Scottsdale Kidney Center LLC | Clinic/Center | 6970 E Chauncey Ln Ste 130, Phoenix, AZ 85054-5159 | 2019-03-22 |
| 1437613916 | Premier Home Dialysis Services | Clinic/Center | 20118 N 67th Ave Ste 300-527, Glendale, AZ 85308-4621 | 2019-01-29 |
| 1801369186 | Bio Medical Applications of Arizona LLC | Clinic/Center | 7862 E Florentine Rd Ste 100, Prescott Valley, AZ 86314-2216 | 2019-01-09 |
| 1932688256 | Southwest Kidney Davita Dialysis Partners LLC | Clinic/Center | 926 E Mcdowell Rd Ste 100, Phoenix, AZ 85006-2503 | 2018-08-08 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on TRC - FOUR CORNERS DIALYSIS CLINICS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.