| Tug River Health Association, Inc | |
|
Us Rt 52 Main Street Gary WV 24836 | |
| (304) 448-2101 | |
| (304) 448-3217 |
| Full Name | Tug River Health Association, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | Us Rt 52 Main Street, Gary, West Virginia |
| Authorized Official Name and Position | Shari Agnew (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3048622588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tug River Health Association, Inc Route 103, Supply St. Pob 507 Gary WV 24836 Ph: (304) 448-2101 | Tug River Health Association, Inc Us Rt 52 Main Street Gary WV 24836 Ph: (304) 448-2101 |
| NPI Number | 1174501068 |
|---|---|
| Provider Enumeration Date | 01/03/2006 |
| Last Update Date | 04/08/2022 |
| Medicare PECOS PAC ID | 7214820547 |
|---|---|
| Medicare Enrollment ID | O20101110000234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174501068 | NPI | - | NPPES |
| CN3563 | Other | WV | RR MEDICARE GROUP # |
| 001706659 | Other | WV | BCBS |
| 0035211000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 031000 (West Virginia) | Primary |
Pineville Children's Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Us Route 103 Supply St, Gary, WV 24836 Phone: 304-732-7069 Fax: 304-732-7098 | |
Tug River Health Association Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rt 103 Supply St, Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
Tug River Health Association, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Rr 103 Supply Street, Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
Tug River Health Association, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Route 103 Supply St., Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
Tug River Health Association, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: Route 103 Supply St., Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 |