| Tri Area Community Health | |
|
14558 Danville Pike Laurel Fork VA 24352-3758 | |
| (276) 398-2292 | |
| (276) 398-3331 |
| Full Name | Tri Area Community Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 14558 Danville Pike, Laurel Fork, Virginia |
| Authorized Official Name and Position | Debra S. Shelor (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2763982292 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri Area Community Health Po Box 9 Laurel Fork VA 24352-0009 Ph: (276) 398-2292 | Tri Area Community Health 14558 Danville Pike Laurel Fork VA 24352-3758 Ph: (276) 398-2292 |
| NPI Number | 1346227584 |
|---|---|
| Provider Enumeration Date | 12/29/2005 |
| Last Update Date | 09/09/2010 |
| Medicare PECOS PAC ID | 6204748296 |
|---|---|
| Medicare Enrollment ID | O20030930000011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346227584 | NPI | - | NPPES |
| 007608942 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Laurel Fork Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1205 Stone Mountain Road, Laurel Fork, VA 24352 Phone: 276-398-2532 Fax: 276-398-2534 |