Organization
TRI-STATE COMMUNITY HEALTH CENTER, INC
Active
Organization
TRI-STATE COMMUNITY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA J DESHONG (EXECUTIVE DIRECTOR)
(301) 678-7256
Entity
Organization
Contact information
Practice address
130 W HIGH ST, HANCOCK, MD 21750-1143
(301) 678-5187
(301) 678-5797
Mailing address
109 RAYLOC DR, HANCOCK, MD 21750-1518
(301) 678-5187
(301) 678-5797
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035061000
—
WV
05
—
1723320/01
—
PA
05
—
482501200
—
MD
Enumeration date
05/09/2006
Last updated
08/03/2010
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