Four Corners Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FOUR CORNERS MEDICAL SUPPLY

Practice address

154 S Main St
Blanding, UT 84511-3733

Phone

(435) 678-2250

NPI assigned

Aug 3, 2006

Last updated

Aug 27, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Tamie J Loibl

Title

Pres

Phone

(970) 565-4200

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Four Corners Medical Supply2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Four Corners Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Cortez, CO
  • NPI 1689609711
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1386652881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-565-4200",
            "fax_number": "970-565-2786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 S MAIN ST",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113733",
            "telephone_number": "435-678-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "LOIBL",
        "authorized_official_first_name": "TAMIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "970-565-4200",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "841071727009",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Exergy Rehabilitation
• Lauren Sloane Fife
• Mahana S Fisher, M.D.
• Jeffrey Fitzgerald
• Four Corners Health Care
• Four Corners Regional Care Center, Inc.
• Vickie Foy, PNP
• Global Pain Clinic LLC (Revival Physical Therapy)
• Madison A Gray
• Guardian Flight LLC

• Durable Medical Equipment & Medical Supplies in Blanding, UT
• Providers in Blanding, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.