Organization
TRI AREA COMMUNITY HEALTH
Active
Other names
Tri Area Community Health at Laurel Fork
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA S. SHELOR (EXECUTIVE DIRECTOR)
(276) 398-2292
Entity
Organization
Contact information
Practice address
14558 DANVILLE PIKE, LAUREL FORK, VA 24352-3758
(276) 398-2292
(276) 398-3331
Mailing address
PO BOX 9, LAUREL FORK, VA 24352-0009
(276) 398-2292
(276) 398-3331
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007608942
—
VA
Enumeration date
12/29/2005
Last updated
09/09/2010
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