Organization
TRISTATE RURAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET STACY (OFFICE MANAGER)
(276) 935-6044
Entity
Organization
Contact information
Practice address
20757 RIVERSIDE DR, GRUNDY, VA 24614-6746
(276) 935-6424
(276) 935-2494
Mailing address
20757 RIVERSIDE DR, GRUNDY, VA 24614-6746
(276) 935-6055
(276) 935-4430
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
0101031664
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006091750
—
VA
Enumeration date
06/11/2008
Last updated
06/11/2008
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