| Tri County Community Health Council Inc | |
|
5531 Eleanor Roosevelt Lane Willard NC 28478 | |
| (877) 935-5255 | |
| (910) 236-2118 |
| Full Name | Tri County Community Health Council Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5531 Eleanor Roosevelt Lane, Willard, North Carolina |
| Authorized Official Name and Position | William C Ellison (REVENUE CYCLE MANAGER) |
| Authorized Official Contact | 9105677065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri County Community Health Council Inc Po Box 340 Four Oaks NC 27524-0340 Ph: (910) 567-6194 | Tri County Community Health Council Inc 5531 Eleanor Roosevelt Lane Willard NC 28478 Ph: (877) 935-5255 |
| NPI Number | 1396768776 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 03/27/2024 |
| Medicare PECOS PAC ID | 2163409558 |
|---|---|
| Medicare Enrollment ID | O20070810000742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396768776 | NPI | - | NPPES |
| 34-1921 | Other | NC | MEDICARE PART A |
| 2804165 | Other | NC | MEDICARE PIN |
| 018KH | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Tri County Community Health Council Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5531 Eleanor Roosevelt Ln, Willard, NC 28478 Phone: 877-935-5255 Fax: 910-236-2118 |