Organization
TRC - FOUR CORNERS DIALYSIS CLINICS LLC
Active
Other names
Shiprock 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
US HIGHWAY 491 NORTH, SHIPROCK, NM 87420-2156
(505) 368-4125
(505) 368-4235
Mailing address
5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN 37027-7569
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
6762
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23752734
—
CO
05
—
485161
—
AZ
05
—
75514
—
NM
Enumeration date
04/20/2006
Last updated
04/21/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us