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General NPI Number Information
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NPI Number | 1225749468
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Entity Type | Organization
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Legal Business Name | TRI AREA COMMUNITY HEALTH
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Dates
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Enumeration Date | 12/08/2022
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Last Update Date | 12/08/2022
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Provider Practice Location Address
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Address Line | 109 CARROLL DR
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City | FRIES
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State | VA
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Zip | 24330-4532
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Country | US
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Telephone | 276-398-2292
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | LAUREL FORK
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State | VA
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Zip | 24352-0009
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Country | US
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Telephone | 276-398-2292
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAMES WERTH JR.
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Credential |
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Telephone | 276-398-2292
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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 |
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