Organization
TRI COUNTY HEALTH CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONNIE JOHNSTON (CFO)
(304) 924-6262
Entity
Organization
Contact information
Practice address
123 QUEENS ALLY ROAD, ROCK CAVE, WV 26234
(304) 924-6784
(304) 924-6891
Mailing address
PO BOX 217, ROCK CAVE, WV 26234-0217
(304) 924-6784
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
SP0552311
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2111511
PK
—
Enumeration date
10/26/2006
Last updated
04/18/2018
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