| 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 - Federally Qualified Health Center (fqhc) |
| Location | 10 Main Street, Northfork, West Virginia |
| Authorized Official Name and Position | Tim Crofton (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3044482101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| 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 | 1992889000 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992889000 | NPI | - | NPPES |
| 6705105000 | Medicaid | WV |
| 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: Medicare Enrolled Practice Location: 10 Main Street, Northfork, WV 24868 Phone: 304-862-2588 Fax: 304-862-2244 |