| Tug River Health Association, Inc | |
|
Us Route 103 Supply St Gary WV 24836 | |
| (304) 732-7069 | |
| (304) 732-7098 |
| Full Name | Tug River Health Association, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | Us Route 103 Supply St, Gary, 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 Po Box 507 Gary WV 24836-0507 Ph: (304) 448-2101 | Tug River Health Association, Inc Us Route 103 Supply St Gary WV 24836 Ph: (304) 732-7069 |
| NPI Number | 1407922891 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 08/03/2021 |
| Medicare PECOS PAC ID | 7214820547 |
|---|---|
| Medicare Enrollment ID | O20081029000906 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407922891 | NPI | - | NPPES |
| 3810014476 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Tug River Health Association, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Us Rt 52 Main Street, Gary, WV 24836 Phone: 304-448-2101 Fax: 304-448-3217 | |
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 |