Organization
TRI COUNTY COMMUNITY HEALTH COUNCIL INC
Active
Other names
CommWell Health of Building Bridges
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C ELLISON (REVENUE CYCLE MANAGER)
(910) 567-7065
Entity
Organization
Contact information
Practice address
417 VANCE ST UNIT B, CLINTON, NC 28328-4001
(910) 567-7107
(910) 299-0486
Mailing address
PO BOX 340, FOUR OAKS, NC 27524-0340
(910) 567-6194
(910) 567-4389
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2804165
MEDICARE PIN
NC
Enumeration date
12/15/2010
Last updated
04/20/2022
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