Organization Name: | TUG RIVER HEALTH ASSOCIATION |
NPI Number: | 1033364765 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIM HARRIS (BILLING SUPERVISOR) |
Mailing Address: | Us Route 10 Pineville |
State: | WV US |
Postal Code: | 248740430 |
Phone Number: | 3047327069 |
Fax Number: | 3047327098 |
NPI Enumeration Date: | 11/21/2008 |
NPI Last Update Date: | 11/21/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |