Organization
TRI COUNTY MEDICAL CENTER, INC
Active
Parent organization
TRI COUNTY MEDICAL CENTER, INC
Other names
Tri County Community Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI COUNTY MEDICAL CENTER, INC
Authorized official
MARILYN J SAWYER (EXECUTIVE DIRECTOR)
(251) 578-1163
Entity
Organization
Contact information
Practice address
COUNTY ROAD 49, LOWER PEACH TREE, AL 36751
(334) 636-2925
Mailing address
PO BOX 726, EVERGREEN, AL 36401-0726
(251) 578-1163
(251) 578-6963
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01D0867799
CLIA NUMBER
AL
Enumeration date
09/23/2008
Last updated
09/24/2008
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