Four Corners Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FOUR CORNERS MEDICAL SUPPLY

Practice address

1108 N Mildred Rd
Cortez, CO 81321

Phone

(970) 565-4200

Fax

(970) 565-2786

NPI assigned

Jul 11, 2006

Last updated

Jun 16, 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
  • Blanding, UT
  • NPI 1386652881
  NPD tax ID

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1689609711",
    "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": "1108 N MILDRED RD",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-565-4200",
            "fax_number": "970-565-2786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-06-16",
        "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": "08012379",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Fitzgerald, PTA
• Megan M Flesch, DPT
• Michael Lynn Ford
• Mark James Foster, PA
• Four Corners Eye Clinic, PC
• Todd R Fowler, M.D.
• Micheal Francisco, MPT
• G & G Medical Inc (A-Med Supply)
• Mary Helen Ganir
• Susan E Garlick

• Durable Medical Equipment & Medical Supplies in Cortez, CO
• Providers in Cortez, CO by specialty
• Durable Medical Equipment & Medical Supplies in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.