TRI COUNTY MEDICAL CENTER, INC (NPI# 1407985344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407985344 |
| Entity Type | Organization |
| Organization Name | TRI COUNTY MEDICAL CENTER, INC |
| Other Organization Name | YEARWOOD MEDICAL CLINIC |
| Practice Address |
1 Milner St Fort Deposit AL 36032-3820 |
| Mailing Address |
Po Box 726 Evergreen AL 36401-0726 |
| Practice Telephone | 3342279991 |
| Practice Fax Number | 3342273226 |
| Mailing Telephone | 2515781163 |
| Mailing Fax Number | 2515786963 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2008-04-08 |
| Authorized Official Name | MARILYN J SAWYER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2515781163 |
| Is Organization Subpart | Y |
| Parent Organization Name | TRI COUNTY MEDICAL CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| YEARWOOD MEDICAL CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740430107 | Tri County Medical Center, Inc | Clinic/Center | County Road 49, Lower Peach Tree, AL 36751 | 2008-09-23 |
| 1609906395 | Tri County Medical Center, Inc | Clinic/Center | 1738 Cleveland Ave, Castleberry, AL 36432 | 2007-03-06 |
| 1548390008 | Tri County Medical Center, Inc | Clinic/Center | 53 Mulberry Street, Frisco City, AL 36445 | 2007-03-06 |
| 1245369313 | Tri County Medical Center, Inc | Clinic/Center | 209 7th Ave, Atmore, AL 36502-2603 | 2007-03-05 |
| 1831228766 | Tri County Medical Center, Inc | Clinic/Center | 138 Jones St, Georgiana, AL 36033-4510 | 2007-03-05 |
| 1184754772 | Tri County Medical Center, Inc | Clinic/Center | 210 Hwy 59 South, Uriah, AL 36480 | 2007-03-06 |
| 1093844060 | Tri County Medical Center, Inc | Clinic/Center | 1115 Azalea Pl, Brewton, AL 36426-1318 | 2007-03-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | TRI COUNTY MEDICAL CENTER, INC. | 417 W Colonels Way, Henryville, IN 47126 |
| Street Address |
1 MILNER ST |
| City | FORT DEPOSIT |
| State | AL |
| Zip Code | 36032-3820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770762643 | Phillip N. Golomb, Md Pa | Family Medicine | 19 Milner Street, Fort Deposit, AL 36032 | 2007-10-29 |
| 1518155373 | Evergreen Dental Center | Dentist | 119 Old Fort Road, Suite B, Fort Deposit, AL 36032 | 2007-10-05 |
| 1124203211 | Fort Deposit Drug Pharmacy LLC | Pharmacy | 120 S Pollard St, Fort Deposit, AL 36032-3825 | 2008-01-08 |
| 1467978346 | Herbert Lamar Barber Jr. | Registered Nurse | 554 Golson Rd E, Fort Deposit, AL 36032-4508 | 2017-08-22 |
| 1508230988 | Kimberly Nacole Jordan | Occupational Therapist | 435 Pine St, Fort Deposit, AL 36032-4740 | 2015-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467978346 | Herbert Lamar Barber Jr. | Registered Nurse | 554 Golson Rd E, Fort Deposit, AL 36032-4508 | 2017-08-22 |
| 1124203211 | Fort Deposit Drug Pharmacy LLC | Pharmacy | 120 S Pollard St, Fort Deposit, AL 36032-3825 | 2008-01-08 |
| 1770762643 | Phillip N. Golomb, Md Pa | Family Medicine | 19 Milner Street, Fort Deposit, AL 36032 | 2007-10-29 |
| 1518155373 | Evergreen Dental Center | Dentist | 119 Old Fort Road, Suite B, Fort Deposit, AL 36032 | 2007-10-05 |
| 1508230988 | Kimberly Nacole Jordan | Occupational Therapist | 435 Pine St, Fort Deposit, AL 36032-4740 | 2015-11-22 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144837311 | Altapointe Health Systems, Inc. | Clinic/Center | 2419 Gordon Smith Dr, Mobile, AL 36617-2318 | 2020-09-30 |
| 1528670452 | The Capstone Rural Health Center | Clinic/Center | 1400 19th St W, Jasper, AL 35501-5171 | 2020-08-21 |
| 1205460268 | The Capstone Rural Health Center | Clinic/Center | 714 12th St W, Jasper, AL 35501-4519 | 2020-02-28 |
| 1184284986 | Health Services, Inc. | Clinic/Center | 1151 Air Base Blvd Ofc, Montgomery, AL 36108-3103 | 2019-06-14 |
| 1982172367 | Health Services, Inc | Clinic/Center | 3350 S Court St, Montgomery, AL 36105-1606 | 2018-11-05 |
| 1932627858 | Whatley Health Services, Inc. | Clinic/Center | 417 3rd St Se, Aliceville, AL 35442 | 2017-08-30 |
| 1780123372 | Quality of Life Health Services, Inc | Clinic/Center | 404 9th Ave Sw, Lafayette, AL 36862-2806 | 2017-02-16 |
| 1487104691 | Whatley Health Services Inc | Clinic/Center | 142 School Street, Oakman, AL 35579 | 2016-10-12 |
| 1831568237 | Quality of Life Health Services, Inc | Clinic/Center | 1502 11th Ave, Phenix City, AL 36867-4905 | 2015-09-16 |
| 1477939031 | Whatley Health Services, Inc. | Clinic/Center | 3601 Stillman Blvd, Tuscaloosa, AL 35401-2601 | 2015-08-06 |
| Find all providers with the same taxonomy | ||||
| City | FORT DEPOSIT |
| Zip Code | 36032 |
Please comment or provide details below to improve the information on TRI COUNTY MEDICAL CENTER, INC.
| 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.