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General NPI Number Information
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NPI Number | 1154226496
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Entity Type | Organization
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Legal Business Name | TRI COUNTY COMMUNITY HEALTH COUNCIL INC.
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 245 LAKEWOOD SCHOOL RD
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City | SALEMBURG
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State | NC
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Zip | 28385-9118
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Country | US
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Telephone | 910-567-6194
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Fax | 910-567-6194
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Provider Business Mailing Address
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Address Line | PO BOX 340
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City | FOUR OAKS
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State | NC
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Zip | 27524-0340
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Country | US
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Telephone | 910-567-6194
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Fax | 910-567-5552
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Authorized Official
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Title or Position | SNR DIRECTOR RCM
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Name | WILLIAM ELLISON
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Credential |
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Telephone | 910-567-7065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | NULL
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