Healthcare Provider Details

I. General information

NPI: 1356596399
Provider Name (Legal Business Name): TRI-MED FAMILY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6120 ALABAMA HWY
RINGGOLD GA
30736-2804
US

IV. Provider business mailing address

PO BOX 729
RINGGOLD GA
30736-0729
US

V. Phone/Fax

Practice location:
  • Phone: 706-935-6442
  • Fax: 706-935-6445
Mailing address:
  • Phone: 706-935-6442
  • Fax: 706-935-6449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: SUZANNE CHOVANEC
Title or Position: CEO
Credential:
Phone: 706-935-6442