| Tri-state Community Health Center, Inc | |
|
525 Fulton Drive Mcconnellsburg PA 17233-1143 | |
| (717) 485-3850 | |
| (717) 485-3725 |
| Full Name | Tri-state Community Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 525 Fulton Drive, Mcconnellsburg, Pennsylvania |
| Authorized Official Name and Position | Sheila J Deshong (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3016785187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Community Health Center, Inc 109 Rayloc Dr Hancock MD 21750-1518 Ph: (301) 678-5187 | Tri-state Community Health Center, Inc 525 Fulton Drive Mcconnellsburg PA 17233-1143 Ph: (717) 485-3850 |
| NPI Number | 1932159464 |
|---|---|
| Provider Enumeration Date | 05/12/2006 |
| Last Update Date | 10/12/2007 |
| Medicare PECOS PAC ID | 9335057355 |
|---|---|
| Medicare Enrollment ID | O20060524000033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932159464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Stephen A Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568482867 PECOS PAC ID: 2961460076 Enrollment ID: I20041221000558 |
| Provider Name | James W Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932143120 PECOS PAC ID: 2264438704 Enrollment ID: I20061006000088 |
| Provider Name | Danielle Ayers Henchey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841625654 PECOS PAC ID: 9638457856 Enrollment ID: I20161024000094 |
| Provider Name | Kristy Dawn Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831603810 PECOS PAC ID: 8729342035 Enrollment ID: I20180514000106 |
| Provider Name | Kelli Renee Oswald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740782366 PECOS PAC ID: 8426306853 Enrollment ID: I20180801002708 |
William L Milroth Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 318 North First Street, Mcconnellsburg, PA 17233 Phone: 717-485-3186 Fax: 717-485-3249 |