Organization
TUG RIVER HEALTH ASSOCIATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM HARRIS (CREDENTIALING SPECIALIST)
(304) 448-2101
Entity
Organization
Contact information
Practice address
RR 103 SUPPLY STREET, GARY, WV 24836-0507
(304) 448-2101
(304) 448-3217
Mailing address
PO BOX 507, RR 103 SUPPLY STREET, GARY, WV 24836-0507
(304) 448-2101
(304) 448-3217
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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