TUG RIVER HEALTH ASSOCIATION, INC. (NPI# 1639658156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639658156 |
| Entity Type | Organization |
| Organization Name | TUG RIVER HEALTH ASSOCIATION, INC. |
| Other Organization Name | PINEVILLE CHILDRENS CLINIC |
| Practice Address |
585 Appalachian Highway Pineville WV 24874-2487 |
| Mailing Address |
Rr 103 Supply Street Po Box 507 Gary WV 24836-0507 |
| Practice Telephone | 3047327069 |
| Practice Fax Number | 3044482101 |
| Mailing Telephone | 3044482101 |
| Mailing Fax Number | 3044482101 |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2018-08-07 |
| Authorized Official Name | KIM HARRIS (CREDENTIALING/ BILLING COORDINATOR) |
| 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 |
| Other Name | Type Code |
|---|---|
| Pineville Childrens Clinic | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1639578065 | Tug River Health Association, Inc. | Clinic/Center | Rr 103 Supply Street, Gary, WV 24836-0507 | 2014-08-21 |
| 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 |
585 APPALACHIAN HIGHWAY |
| City | PINEVILLE |
| State | WV |
| Zip Code | 24874-2487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013204734 | Joanna Marie Adkins Bailey | Family Medicine | 585 Appalachian Highway, Pineville, WV 24874-0430 | 2011-07-01 |
| 1457830978 | Tug River Health Association, Inc. | Clinical Medical Laboratory | 585 Appalachian Highway, Pineville, WV 24817 | 2018-08-07 |
| 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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| 1033364765 | Tug River Health Association | Clinic/Center | Us Route 10, Pineville, WV 24874-0430 | 2008-11-21 |
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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.