Organization
TRC - FOUR CORNERS DIALYSIS CLINICS LLC
Active
Other names
Cortez Dialysis Center
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T WEY (VP, LICENSURE & CERTIFICATION)
(615) 341-6641
Entity
Organization
Contact information
Practice address
610 E MAIN ST, STE C, CORTEZ, CO 81321
(970) 565-4302
(970) 565-4374
Mailing address
5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
1212SP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184691909
—
CO
Enumeration date
03/01/2006
Last updated
03/13/2025
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