Organization
TUG RIVER HEALTH ASSOCIATION, INC.
Active
Other names
Tug River/River View Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
TIM A CROFTON MBA (CEO)
(304) 448-2101
Entity
Organization
Contact information
Practice address
512 MOUNTAINEER HIGHWAY, ROOM 1344, BRADSHAW, WV 24817-0000
(304) 967-7682
(304) 967-7684
Mailing address
ROUTE 103 SUPPLY STREET, PO BOX 507, GARY, WV 24836-0507
(304) 448-2101
(304) 448-3217
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810021840
—
WV
Enumeration date
03/02/2011
Last updated
12/12/2011
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