| Tug River Health Association, Inc. | |
|
512 Mountaineer Highway Room 1344 Bradshaw WV 24817-0000 | |
| (304) 967-7682 | |
| (304) 967-7684 |
| Full Name | Tug River Health Association, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 512 Mountaineer Highway, Bradshaw, West Virginia |
| Authorized Official Name and Position | Tim A Crofton (CEO) |
| 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 24836-0507 Ph: (304) 448-2101 | Tug River Health Association, Inc. 512 Mountaineer Highway Room 1344 Bradshaw WV 24817-0000 Ph: (304) 967-7682 |
| NPI Number | 1295033009 |
|---|---|
| Provider Enumeration Date | 03/02/2011 |
| Last Update Date | 12/12/2011 |
| Medicare PECOS PAC ID | 7214820547 |
|---|---|
| Medicare Enrollment ID | O20110929000113 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295033009 | NPI | - | NPPES |
| 3810021840 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mahesh B. Patel Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9981 Marshall Highway, Bradshaw, WV 24817 Phone: 304-967-5034 Fax: 304-906-2417 |