Organization · Type 2 NPI

TRC - Four Corners Dialysis Clinics LLC

End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Farmington, NM

NPI number 1306499405 Active

Practice location

4525 Rowe Ave
Farmington, NM 87402-3013

Call (505) 326-9102 Map

Fax (505) 326-6633

Mailing address

5200 Virginia Way, Att: L&c Department
Brentwood, TN 37027

Specialties and licenses

Taxonomy	Code	License
End-Stage Renal Disease (ESRD) Treatment Clinic/Center Primary	261QE0700X	None listed

End-Stage Renal Disease (ESRD) Treatment Clinic/Center: Definition to come...

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NPI record

NPI: 1306499405
Entity type: Organization (Type 2)
Issued: Jul 18, 2019
Last updated: Apr 16, 2026
Status: Active

Other names

<unavail>
San Juan Dialysis · doing business as
San Juan Dialysis · doing business as

Authorized official

Samuel T Wey
VP, Licensure & Certification
(615) 341-6641

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1306499405

TRC - Four Corners Dialysis Clinics LLC's National Provider Identifier is 1306499405, issued on Jul 18, 2019. The primary taxonomy on file is End-Stage Renal Disease (ESRD) Treatment Clinic/Center (261QE0700X), and the practice location is in Farmington, NM. The record was last updated on Apr 16, 2026.