Healthcare Provider Details

I. General information

NPI: 1043658537
Provider Name (Legal Business Name): TRI AREA COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2013
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FERRUM MOUNTAIN RD
FERRUM VA
24088-2939
US

IV. Provider business mailing address

PO BOX 9
LAUREL FORK VA
24352-0009
US

V. Phone/Fax

Practice location:
  • Phone: 540-365-9992
  • Fax: 540-365-2718
Mailing address:
  • Phone: 276-398-1200
  • Fax: 540-365-2718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number0201004119
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0201004119
License Number StateVA

VIII. Authorized Official

Name: JAMES L WERTH JR.
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 276-398-2292