Tug River Health Association, INC.
Clinic/Center, Federally Qualified Health Center (FQHC) in Bradshaw, WV. Organization (NPI-2).
NPI number1295033009
StatusActive
Last updated in NPPESDec 12, 2011
Details
- NPI
- 1295033009
- Entity type
- Organization (NPI-2)
- Legal business name
- Tug River Health Association, INC.
- Organization subpart
- No
- Enumeration date
- Mar 2, 2011
- Last updated
- Dec 12, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | Yes |
Other names
- Tug River/River View Wellness Center (Other Name)
Practice location
512 Mountaineer HighwayRoom 1344
Bradshaw, WV 24817-0000
Phone 304-967-7682 · Fax 304-967-7684
Mailing address
Route 103 Supply StreetPo Box 507
Gary, WV 24836-0507
Phone 304-448-2101 · Fax 304-448-3217
Authorized official
Tim A Crofton
Ceo
3044482101
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