TUG RIVER HEALTH ASSOCIATION, INC (NPI# 1992889000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992889000 |
| Entity Type | Organization |
| Organization Name | TUG RIVER HEALTH ASSOCIATION, INC |
| Practice Address |
10 Main Street Northfork WV 24868 |
| Mailing Address |
Route 103 Supply Street, Po Box 507 Gary WV 24836 |
| Practice Telephone | 3048622588 |
| Practice Fax Number | 3048622244 |
| Mailing Telephone | 3044482101 |
| Mailing Fax Number | 3044483217 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TIM CROFTON (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3044482101 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
031000 | WV | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 6705105000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407922891 | Tug River Health Association, Inc | Clinic/Center | Us Route 103 Supply St, Gary, WV 24836 | 2006-11-28 |
| 1013093350 | Tug River Health Association, Inc | Clinic/Center | 950 Mount View Rd, Suite 500, Welch, WV 24801-2810 | 2006-10-30 |
| 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 |
| 1831275171 | Tug River Health Association, Inc | Clinic/Center | Route 103 Supply St., Gary, WV 24836 | 2006-10-30 |
| 1831273945 | Tug River Health Association, Inc | Clinic/Center | 10 Main Street, Northfork, WV 24868 | 2006-10-25 |
| 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 |
10 MAIN STREET |
| City | NORTHFORK |
| State | WV |
| Zip Code | 24868 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831273945 | Tug River Health Association, Inc | Clinic/Center | 10 Main Street, Northfork, WV 24868 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508808007 | Andres Laurente Rago | Family Medicine | 135 Main Street, Keystone, WV 24868 | 2006-06-11 |
| 1720133986 | Wideners Ambulance Service, Inc | Ambulance | 102 Main Street, Northfork, WV 24868 | 2007-01-25 |
| 1891880506 | Harold Anthony Cofer Jr. | Family Medicine | Main St, Northfolk, WV 24868 | 2006-10-04 |
| 1710156740 | Csm | Case Management | 69 Main Street, 3rd, Northfork, WV 24868-0085 | 2008-02-25 |
| 1366625915 | Council of The Southern Mountains | Case Management | 69 Main St., Northfork, WV 24868-0085 | 2007-12-06 |
| 1881716611 | Council of The Southern Mountains | Day Training, Developmentally Disabled Services | 69 Main St., Old Keystone Bank Building, Keystone, WV 24868-0085 | 2007-04-04 |
| 1225114184 | Council of The Southern Mountains, Wv Branch, Mcdowell Co Chapter, Inc | Day Training, Developmentally Disabled Services | 69 Main Street, City of Keystone Building, Keystone, WV 24868-0085 | 2006-10-31 |
| 1558444026 | Black Diamond Pharmacy, LLC | Pharmacy | 33800 Coal Heritage Road, Northfork, WV 24868-0397 | 2006-10-20 |
| 1851998504 | Crystal T Flaherty | Technician | 5293 Cherokee Rd, Northfork, WV 24868-8103 | 2020-10-06 |
| 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 |
|---|---|---|---|---|
| 1831273945 | Tug River Health Association, Inc | Clinic/Center | 10 Main Street, Northfork, WV 24868 | 2006-10-25 |
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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.