Organization
TRI COUNTY COMMUNITY HEALTH COUNCIL INC.
Active
Other names
CommWell Health
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C ELLISON (REVENUE CYCLE MANAGER)
(910) 567-7065
Entity
Organization
Contact information
Practice address
1508 MAPLE GROVE CHURCH RD STE B, DUNN, NC 28334-7688
(877) 935-5255
(910) 236-2118
Mailing address
PO BOX 340, FOUR OAKS, NC 27524-0340
(910) 567-6194
(910) 567-5552
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
MHL082078
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34-1973
MEDICARE OSCAR
NC
05
—
5917548
—
NC
05
—
6008040
—
NC
05
—
8302723
—
NC
Enumeration date
04/23/2009
Last updated
03/27/2024
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