Organization
TRI COUNTY COMMUNITY HEALTH COUNCIL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C ELLISON (REVENUE CYCLE MANAGER)
(910) 567-7065
Entity
Organization
Contact information
Practice address
507 N BRIGHTLEAF BLVD, SUITE 209, SMITHFIELD, NC 27577-4405
(877) 935-5255
(910) 236-2118
Mailing address
PO BOX 340, FOUR OAKS, NC 27524-0340
(910) 957-6194
(910) 567-5342
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341928
MEDICARE OSCAR
NC
Enumeration date
12/13/2007
Last updated
03/27/2024
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