Organization
FOUR LEAF CLOVER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM F. SWEENEY (OWNER/PRESIDENT)
(888) 777-3203
Entity
Organization
Contact information
Practice address
3280 HWY 69, SUITE II, HAYESVILLE, NC 28904-1007
(888) 777-3203
(828) 389-9778
Mailing address
3280 HWY 69, SUITE II, HAYESVILLE, NC 28904-1007
(888) 777-3203
(828) 389-9779
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1035023
NC
332B00000X
Durable Medical Equipment & Medical Supplies
2004-16341
FL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000965346A
—
GA
05
—
001963766
—
PA
05
—
003107887
—
CT
05
—
00440785
—
MS
05
—
100454120 A
—
KS
05
—
145573501
—
TX
05
—
146926741
—
AR
05
—
182741
—
OR
05
—
200003930 A
—
OK
05
—
200408900 A
—
IN
05
—
2254804
—
OH
05
—
4503699
—
MI
05
—
4582201
—
TN
05
—
464074
—
AZ
01
—
600678485
NC STATE ID
NC
05
—
65-509-5427-001
—
IL
05
—
7703099
—
NC
05
—
7777027 00
—
MD
05
—
9000515800
—
KY
01
—
R8517
BLUE CROSS BLUE SHIELD
—
Enumeration date
11/09/2006
Last updated
08/26/2010
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