Organization
TUG RIVER HEALTH ASSOCIATION, INC.
Active
Other names
Tug River/Riverview Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
KIM HARRIS (CREDENTIALING/BILLING COORD.)
(304) 448-2101
Entity
Organization
Contact information
Practice address
512 MOUNTAINEEER HIGHWAY, ROOM 1344, BRADSHAW, WV 24874-2487
(304) 967-7684
Mailing address
RR 103 SUPPLY STREET, PO BOX 507, GARY, WV 24836
(304) 448-2101
(304) 448-3217
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
51D1064007
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810021840
—
WV
Enumeration date
08/07/2018
Last updated
08/07/2018
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