Organization
TUG RIVER HEALTH ASSOCIATION, INC
Active
Parent organization
TUG RIVER HEALTH ASSOCIATION, INC
Other names
Tug River Health Association
Organization subpart
Yes
Provider details
NPI number
Legal business name
TUG RIVER HEALTH ASSOCIATION, INC
Authorized official
SHARON G AGNEW (CREDENTIALING SPECIALIST)
(304) 862-2588
Entity
Organization
Contact information
Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 431-1400
Mailing address
200 12TH STREET EXT, PRINCETON, WV 24740-2329
(304) 431-1400
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639842818
—
WV
Enumeration date
07/26/2021
Last updated
03/28/2022
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