# TRI STATE CLINIC, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tri State Rural Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124097795
- **Authorized official:** MRS. JANET STACY (ADMINISTRATOR)
- **Authorized official phone:** (276) 935-8620

## Contact information

- **Practice address:** 1520 SLATE CREEK RD, GRUNDY, VA 24614-6975
- **Practice address phone:** (276) 935-8620
- **Practice address fax:** (276) 935-4430
- **Mailing address:** 1520 SLATE CREEK RD, GRUNDY, VA 24614-6975
- **Mailing address phone:** (276) 935-8620
- **Mailing address fax:** (276) 935-4430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 03/16/2006
- **Last updated:** 03/09/2010