Provider Demographics
NPI:1073986758
Name:4 CORNERS HHC
Entity Type:Organization
Organization Name:4 CORNERS HHC
Other - Org Name:FOUR CORNERS HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-716-3421
Mailing Address - Street 1:301 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLANDING
Mailing Address - State:UT
Mailing Address - Zip Code:84511-3831
Mailing Address - Country:US
Mailing Address - Phone:505-716-3421
Mailing Address - Fax:
Practice Address - Street 1:421 E SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:GRANTS
Practice Address - State:NM
Practice Address - Zip Code:87020-2499
Practice Address - Country:US
Practice Address - Phone:505-716-3421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-03
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health