FOUR CORNERS LLC (NPI# 1700362738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700362738 |
| Entity Type | Organization |
| Organization Name | FOUR CORNERS LLC |
| Practice Address |
1704 Llano St Ste B Santa Fe NM 87505-5415 |
| Mailing Address |
5761 W Park Ave Chandler AZ 85226-1241 |
| Practice Telephone | 5203399276 |
| Mailing Telephone | 5203399726 |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |
| Authorized Official Name | MR. OSAMA WALI (GENERAL MANAGER) |
| Authorized Official Telephone | 5203399726 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 172A00000X | Driver | NM | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 5696496 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Four Corners LLC | 901 Draper Rd, Blacksburg, Virginia 24060 |
| Street Address |
1704 LLANO ST STE B |
| City | SANTA FE |
| State | NM |
| Zip Code | 87505-5415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386003218 | Prentice Chatfield | Counselor | 1704 Llano St Ste B, #237, Santa Fe, NM 87505-5415 | 2016-02-20 |
| 1457974222 | Tele-peds LLC | Pediatrics | 1704 Llano St Ste B, Santa Fe, NM 87505-5415 | 2020-05-27 |
| 1346873783 | Precious Marie Moya-mier | Behavior Technician | 1704 Llano St Ste B, Santa Fe, NM 87505-5415 | 2020-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154939031 | Enchanted Sky Hospice,llc | Hospice Care, Community Based | 1692b Hospital Drive, Vigil Office Building, Suite 201a, Santa Fe, NM 87505 | 2020-07-16 |
| 1700409968 | Caa Consulting, LLC | Clinic/Center | 1448 S St. Francis Drive, Santa Fe, NM 87505 | 2020-05-22 |
| 1104447093 | Dana Marie Tsyconyea Simmons | Counselor | 1640 Calle Medico, Suite E, Santa Fe, NM 87505 | 2020-05-01 |
| 1114574217 | Kumara Hampton Therapy, LLC | Counselor | 11 Calle Medico Suite 4, Santa Fe, NM 87505 | 2019-08-22 |
| 1245886977 | Caroline Ward | Technician | 513 Velarde St 513 Velarde St, Santa Fe, NM 87505 | 2019-08-19 |
| 1205490752 | Alyson Yacono | Physical Therapist | 104 Old Las Vegas Highway, Santa Fe, NM 87505 | 2019-04-30 |
| 1366919649 | Allyson Matthews | Speech-Language Pathologist | Santa Fe Public Schools Special Education Department, 1300 Camino Sierra Vista, Santa Fe, NM 87505 | 2018-10-25 |
| 1093280281 | Diamond Care Santa Fe LLC | Skilled Nursing Facility | 635 Harkle Road, Santa Fe, NM 87505 | 2018-10-04 |
| 1972087054 | Changing Woman Initiative | Advanced Practice Midwife | 460 Saint Michaels Drive, Suite 804, Santa Fe, NM 87505 | 2018-09-24 |
| 1154812782 | Heart Wing, LLC | Social Worker | 2724 Alamosa Drive, Santa Fe, NM 87505 | 2018-05-18 |
| Find all providers in zip 87505 | ||||
| Taxonomy Code | 172A00000X |
| Grouping | Other Service Providers |
| Classification | Driver |
| A person employed to operate a motor vehicle as a carrier of persons or property. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528698529 | Nooreddeen Alsadi | Driver | 3850 E Highway 66, Gallup, NM 87301-4589 | 2020-01-19 |
| 1740820174 | Ibrahim Sulaiman Hemaada | Driver | 7600 Montgomery Blvd Ne Apt 1065, Albuquerque, NM 87109-1523 | 2020-01-14 |
| 1073072427 | Ronald James Fitzherbert | Driver | 1751 W Hadley Ave Trlr 158, Las Cruces, NM 88005-8158 | 2019-03-15 |
| 1619432663 | Marissa Paulette Gomez | Driver | 12200 Montgomery Blvd Ne Apt D202, Albuquerque, NM 87111-4197 | 2019-02-04 |
| 1336516061 | Stephanie Betts | Driver | 2990 N Main St Ste 3a, Las Cruces, NM 88001-1195 | 2015-08-28 |
| 1396168548 | Ronnie Hicks | Driver | 9600 Central Ave Sw Trlr 148, Albuquerque, NM 87121-7681 | 2014-01-23 |
| 1972948297 | Lyric Jackson | Driver | 3513 Plano Vista Ne, Rio Rancho, NM 87124 | 2013-04-30 |
| 1497199988 | Christian Obeji | Driver | 3513 Plano Vista Rd Ne, Rio Rancho, NM 87124-4183 | 2013-04-26 |
| 1972852382 | Ismail Mohamed Ismail | Driver | 933 San Mateo Blvd Ne Ste 500, Albuquerque, NM 87108-1862 | 2012-08-30 |
| 1346515475 | Margo G Bencomo | Driver | 3325 Valverde Loop, Las Cruces, NM 88012-8550 | 2012-03-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.