TUG RIVER HEALTH ASSOCIATION, INC. (NPI# 1639578065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639578065 |
| Entity Type | Organization |
| Organization Name | TUG RIVER HEALTH ASSOCIATION, INC. |
| Practice Address |
Rr 103 Supply Street Gary WV 24836-0507 |
| Mailing Address |
Po Box 507 Rr 103 Supply Street Gary WV 24836-0507 |
| Practice Telephone | 3044482101 |
| Practice Fax Number | 3044483217 |
| Mailing Telephone | 3044482101 |
| Mailing Fax Number | 3044483217 |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |
| Authorized Official Name | MRS. KIM HARRIS (CREDENTIALING SPECIALIST) |
| 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) |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720567241 | Tug River Health Association, Inc. | Clinical Medical Laboratory | 512 Mountaineeer Highway, Room 1344, Bradshaw, WV 24874-2487 | 2018-08-07 |
| 1295033009 | Tug River Health Association, Inc. | Clinic/Center | 512 Mountaineer Highway, Room 1344, Bradshaw, WV 24817-0000 | 2011-03-02 |
| 1639658156 | Tug River Health Association, Inc. | Clinic/Center | 585 Appalachian Highway, Pineville, WV 24874-2487 | 2018-08-07 |
| 1548749062 | Tug River Health Association, Inc. | Clinical Medical Laboratory | 950 Mount View Rd, Welch, WV 24801-2810 | 2018-08-07 |
| 1457830978 | Tug River Health Association, Inc. | Clinical Medical Laboratory | 585 Appalachian Highway, Pineville, WV 24817 | 2018-08-07 |
| 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 |
RR 103 SUPPLY STREET |
| City | GARY |
| State | WV |
| Zip Code | 24836-0507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255326088 | John Roger Ray | Family Medicine | Rr 103 Supply Street, Gary, WV 24836-0507 | 2005-09-19 |
| 1609427350 | Jessica Robin Marcus | Nurse Practitioner | Rr 103 Supply Street, Gary, WV 24836 | 2019-09-24 |
| 1942559364 | Keisha R Saunders | Nurse Practitioner | Rr 103 Supply Street, Gary, WV 24836-0507 | 2012-08-30 |
| 1285989152 | Angela G Mckinney | Nurse Practitioner | Rr 103 Supply Street, Gary, WV 24836-0507 | 2012-07-17 |
| 1164658118 | Joseph Clary Kirkpatrick | General Practice | Rr 103 Supply Street, Gary, WV 24836-0507 | 2009-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725292 | Tracey L Lester | Family Medicine | 103 Supply Street, Gary, WV 24836 | 2019-11-20 |
| 1912556507 | Tamera Beth Ball | Nurse Practitioner | 150 Venus Drive, Gary, WV 24836 | 2019-09-06 |
| 1366674541 | Veronica Marie Brown | Dentist | Rt. 103 Supply Street, Gary, WV 24836 | 2009-08-20 |
| 1558528554 | Cristie D Hatfield | Dental Hygienist | Route 103 Supply St, Gary, WV 24836 | 2008-05-19 |
| 1548382435 | Tug River Health Association | Clinic/Center | Rt 103 Supply St, Gary, WV 24836 | 2007-04-04 |
| 1407922891 | Tug River Health Association, Inc | Clinic/Center | Us Route 103 Supply St, Gary, WV 24836 | 2006-11-28 |
| 1922184266 | Tug River Health Association, Inc | Clinic/Center | Route 103 Supply St., Gary, WV 24836 | 2006-10-30 |
| 1992887392 | John W Balaban | Dentist | Route 103, Supply St, Gary, WV 24836 | 2006-10-19 |
| 1245286137 | David R Carr | Family Medicine | Route 103 Supply Street, Gary, WV 24836 | 2006-05-25 |
| 1174501068 | Tug River Health Association, Inc | Clinic/Center | Us Rt 52 Main Street, Gary, WV 24836 | 2006-01-03 |
| Find all providers in zip 24836 | ||||
| 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 |
|---|---|---|---|---|
| 1548861313 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1100 W 5th Ave, Gary, IN 46402-1723 | 2020-11-06 |
| 1003371220 | Porter Starke Services Inc | Clinic/Center | Marram Health Center, 3229 Broadway Suite 160, Gary, IN 46409-1040 | 2019-02-01 |
| 1891262762 | Community Healthnet Inc | Clinic/Center | 3503 Martin Luther King Drive, Community Healthnet Inc - East, Gary, IN 46409-1233 | 2018-10-30 |
| 1023485356 | Porter-starke Services Inc. | Clinic/Center | 3229 Broadway Ste 115, Gary, IN 46409-1040 | 2015-08-21 |
| 1548382435 | Tug River Health Association | Clinic/Center | Rt 103 Supply St, Gary, WV 24836 | 2007-04-04 |
| 1922184266 | Tug River Health Association, Inc | Clinic/Center | Route 103 Supply St., Gary, WV 24836 | 2006-10-30 |
| 1174501068 | Tug River Health Association, Inc | Clinic/Center | Us Rt 52 Main Street, Gary, WV 24836 | 2006-01-03 |
| 1407457591 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 3535 Broadway, Gary, IN 46409-1316 | 2020-11-04 |
| 1598316978 | Edgewater Systems for Balanced Living, Inc | Clinic/Center | 1100 W 6th Ave, Gary, IN 46402-1711 | 2019-09-26 |
| 1497007876 | Community Healthnet | Clinic/Center | 1015 N Shelby St, Gary, IN 46403-1446 | 2012-10-09 |
| Find all providers in GARY | ||||
Please comment or provide details below to improve the information on TUG RIVER HEALTH ASSOCIATION, 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.