TUG RIVER HEALTH ASSOCIATION (NPI# 1033364765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033364765 |
| Entity Type | Organization |
| Organization Name | TUG RIVER HEALTH ASSOCIATION |
| Other Organization Name | PINEVILLE CHILDREN'S CLINIC |
| Practice Address |
Us Route 10 Pineville WV 24874-0430 |
| Mailing Address |
Po Box 507 Gary WV 24836-0507 |
| Practice Telephone | 3047327069 |
| Practice Fax Number | 3047327098 |
| Mailing Telephone | 3044482101 |
| Mailing Fax Number | 3044483217 |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2008-11-21 |
| Authorized Official Name | MRS. KIM HARRIS (BILLING SUPERVISOR) |
| Authorized Official Telephone | 3044482101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | CLIA CERT # | 51D0233700 | 01 |
| Other Name | Type Code |
|---|---|
| Pineville Children's Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548382435 | Tug River Health Association | Clinic/Center | Rt 103 Supply St, Gary, WV 24836 | 2007-04-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TUG RIVER HEALTH ASSOCIATION, INC | Rt 103 Supply St, Gary, WV 24836-0507 |
| Street Address |
US ROUTE 10 |
| City | PINEVILLE |
| State | WV |
| Zip Code | 24874-0430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851999775 | Frankie Lynn Adkins | Technician | 91 Blackberry St, Pineville, WV 24874 | 2020-10-13 |
| 1104430313 | Leeann Mae Morgan | Technician | 457 Bowman Bottom Rd, Pineville, WV 24874 | 2020-09-04 |
| 1093329757 | Destiny Lafferty | Technician | 457 Bowman Bottom Rd., Pineville, WV 24874 | 2020-09-01 |
| 1942813027 | Jenny Marie Hatfield | Technician | 308 River View Ave, Pineville, WV 24874 | 2020-08-28 |
| 1124591920 | Ashley Nicole Lusk | Counselor | 438 River Drive, Pineville, WV 24874 | 2019-01-04 |
| 1174040604 | Walgreen Co | Pharmacy | 448 Appalachian Hwy, Pineville, WV 24874 | 2017-08-25 |
| 1265719256 | Stat Ems, LLC. | Non-emergency Medical Transport (VAN) | 84-b Main Ave, Pineville, WV 24874 | 2011-11-04 |
| 1225337652 | Omotayo Julieanne Aborisade | Pharmacist | Route 10, Main Strret, Pineville, WV 24874 | 2011-03-24 |
| 1609175520 | Irene B Menego | Pharmacist | 418 Applician Highway, Pineville, WV 24874 | 2011-03-17 |
| 1396989604 | Angela Kaye Cook | Psychologist | 483 Appalachian Highway, Suite 2, Pineville, WV 24874 | 2009-04-30 |
| Find all providers in zip 24874 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1609358159 | Mountain Comprehensive Health Corporation | Clinic/Center | 401 W Virginia Ave Ste A, Pineville, KY 40977-1321 | 2018-08-31 |
| 1639658156 | Tug River Health Association, Inc. | Clinic/Center | 585 Appalachian Highway, Pineville, WV 24874-2487 | 2018-08-07 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.