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Organization
FOUR CORNERS AMBULATORY SURGERY CENTER, LLC
Active
Organization
FOUR CORNERS AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLES REDWING FACMPE (EXECUTIVE DIRECTOR)
(505) 564-2300
Entity
Organization
Contact information
Practice address
2300 E 30TH ST BLDG A, FARMINGTON, NM 87401-8991
(505) 564-2300
(505) 564-2210
Mailing address
2300 E 30TH ST BLDG A, FARMINGTON, NM 87401-8991
(505) 564-2300
(505) 564-2210
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
6701
NM
Other
Enumeration date
11/20/2006
Last updated
04/08/2010
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