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
621 KELLY RD, CUMBERLAND, MD 21502-2878
(301) 722-3270
(301) 722-3276
Mailing address
130 W HIGH ST, HANCOCK, MD 21750-1143
(301) 678-7256
(301) 678-8007
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035061003
—
WV
05
—
1723320/02
—
PA
05
—
482501201
—
MD
Enumeration date
05/12/2006
Last updated
10/14/2008
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