Organization
TUG RIVER HEALTH ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN E WRIGHT RN, MBA (DIR CLINICAL SERVICES)
(304) 448-2101
Entity
Organization
Contact information
Practice address
RT 103 SUPPLY ST, GARY, WV 24836
(304) 448-2101
(304) 448-3217
Mailing address
RT 103 SUPPLY ST, GARY, WV 24836
(304) 448-2101
(304) 448-3217
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DENTAL
DENTAL CLINIC
WV
Enumeration date
04/04/2007
Last updated
07/21/2022
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