TRI-STATE COMMUNITY HEALTH CENTER, INC (NPI# 1366491201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366491201 |
| Entity Type | Organization |
| Organization Name | TRI-STATE COMMUNITY HEALTH CENTER, INC |
| Practice Address |
130 W High St Hancock MD 21750-1143 |
| Mailing Address |
109 Rayloc Dr Hancock MD 21750-1518 |
| Practice Telephone | 3016785187 |
| Practice Fax Number | 3016785797 |
| Mailing Telephone | 3016785187 |
| Mailing Fax Number | 3016785797 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2010-08-03 |
| Authorized Official Name | MRS. SHEILA J DESHONG (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3016787256 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 482501200 | 05 | |
| WV | 0035061000 | 05 | |
| PA | 1723320/01 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932159464 | Tri-state Community Health Center, Inc | Clinic/Center | 525 Fulton Drive, Mcconnellsburg, PA 17233-1143 | 2006-05-12 |
| 1659709277 | Tri-state Community Health Center, Inc | Nurse Practitioner | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2013-10-16 |
| 1083055081 | Tri-state Community Health Center, Inc | Clinic/Center | 261 Berkmore Pl, Suite 1a, Berkeley Springs, WV 25411-6247 | 2013-07-08 |
| 1457301939 | Tri-state Community Health Center, Inc | Clinic/Center | 621 Kelly Rd, Cumberland, MD 21502-2878 | 2006-05-12 |
| 1467401372 | Tri-state Community Health Center, Inc | Clinic/Center | 12502 Willowbrook Road, Ste 550, 5th Flr., Cumberland, MD 21502-6393 | 2006-05-08 |
| Street Address |
130 W HIGH ST |
| City | HANCOCK |
| State | MD |
| Zip Code | 21750-1143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538122312 | Meredith Minto Williams | Pediatrics | 130 W High St, Hancock, MD 21750-1143 | 2006-04-11 |
| 1750930293 | Rebecca Wiles | Nurse Practitioner | 130 W High St, Hancock, MD 21750-1143 | 2019-09-07 |
| 1669982872 | Mark Anthony Roncone | Nurse Practitioner | 130 W High St, Hancock, MD 21750-1143 | 2017-10-03 |
| 1518296615 | Liza Dawn Hiles | Family Medicine | 130 W High St, Hancock, MD 21750-1199 | 2009-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821644253 | Craig Wesley Hatcher | Pharmacist | 343 N. Pennsylvania Ave., Hancock, MD 21750 | 2019-08-12 |
| 1467501692 | War Memorial Hospital, Inc. | Family Medicine | 351 N Pennsylvania Ave, Hancock, MD 21750 | 2007-01-09 |
| 1528086022 | James H Dolly | Optometrist | 263 N Pennsylvania Avenue, Hancock, MD 21750 | 2006-07-17 |
| 1639654007 | Lora Cole | Registered Nurse | 131 N Pennsylvania Ave, Hancock, MD 21750 | 2018-10-01 |
| 1144260662 | Wheeler's Optical Inc. | Technician/Technologist | 263 N Pennsylvania Ave, Hancock, MD 21750-1042 | 2006-06-07 |
| 1144860396 | Chesapeake Eye Care & Laser Center LLC | Technician/Technologist | 263 N Pennsylvania Ave, Hancock, MD 21750-1042 | 2020-01-15 |
| 1912312760 | Maryland Vision Institute, LLC | Eyewear Supplier (Equipment, not the service) | 263 N Pennsylvania Ave, Hancock, MD 21750-1042 | 2014-06-30 |
| 1114065596 | Rphc LLC | Pharmacy | 343 N Pennsylvania Ave, Hancock, MD 21750-1046 | 2007-02-01 |
| 1235335829 | Amanda Brooke Bauler | Nurse Practitioner | 351 N Pennsylvania Ave, Hancock, MD 21750-1046 | 2007-06-21 |
| 1053515759 | Amy F Hatcher | Pharmacist | 343 N Pennsylvania Ave, Hancock, MD 21750-1046 | 2007-06-14 |
| Find all providers in zip 21750 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
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| 1659792026 | Upper Great Lakes Family Health Center | Clinic/Center | 500 Campus Drive, Hancock, MI 49930-1569 | 2014-01-02 |
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| 1689160848 | West Cecil Health Center Inc. | Clinic/Center | 200 Road B, Elkton, MD 21921-6695 | 2018-07-10 |
| 1841786001 | West Cecil Health Center Inc. | Clinic/Center | 100 E Bel Air Ave, Aberdeen, MD 21001-3837 | 2018-07-10 |
| 1598251753 | West Cecil Health Center Inc. | Clinic/Center | 233 S Bohemia Ave, Cecilton, MD 21913-1010 | 2018-07-10 |
| 1811403264 | Mary's Center for Maternal and Child Care, Inc- Smart | Clinic/Center | 8910 Riggs Rd, Adelphi, MD 20783-1632 | 2017-12-21 |
| 1669985032 | Choptank Community Health System Inc | Clinic/Center | 21374 Foster Ave, Tilghman, MD 21671-1230 | 2017-11-08 |
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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.