Organization
CLINCH RIVER HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GILLIAM (ADMINISTRATOR)
(276) 467-2201
Entity
Organization
Contact information
Practice address
17633 VETERANS MEMORIAL HWY, SUITE 101, DUNGANNON, VA 24245
(276) 467-2201
(276) 467-2673
Mailing address
17633 VETERANS MEMORIAL HWY, SUITE 101, DUNGANNON, VA 24245
(276) 467-2201
(276) 467-2673
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007639431
—
VA
Enumeration date
01/11/2006
Last updated
02/25/2022
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