| Tug River Health Association, Inc | |
|
10 Main Street Northfork WV 24868 | |
| (304) 862-2588 | |
| (304) 862-2244 |
| Full Name | Tug River Health Association, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10 Main Street, Northfork, West Virginia |
| Authorized Official Name and Position | Kim Harris (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 3044482101 |
| 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 Street, Po Box 507 Gary WV 24836 Ph: (304) 448-2101 | Tug River Health Association, Inc 10 Main Street Northfork WV 24868 Ph: (304) 862-2588 |
| NPI Number | 1831273945 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 12/06/2018 |
| Medicare PECOS PAC ID | 7214820547 |
|---|---|
| Medicare Enrollment ID | O20101110000239 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831273945 | NPI | - | NPPES |
| 0035035000 | Medicaid | WV | |
| 001706659 | Other | WV | MS BCBS |
| CN3563 | Other | WV | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 031000 (West Virginia) | Primary |
Tug River Health Association, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Main Street, Northfork, WV 24868 Phone: 304-862-2588 Fax: 304-862-2244 |