Provider Demographics
NPI:1376142281
Name:TRI AREA COMMUNITY HEALTH
Entity Type:Organization
Organization Name:TRI AREA COMMUNITY HEALTH
Other - Org Name:TRI-AREA COMMUNITY HEALTH AT GRAYSON HIGHLANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:WERTH
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:276-398-2292
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:LAUREL FORK
Mailing Address - State:VA
Mailing Address - Zip Code:24352-0009
Mailing Address - Country:US
Mailing Address - Phone:276-398-2292
Mailing Address - Fax:276-398-3331
Practice Address - Street 1:6436 TROUTDALE HWY
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:VA
Practice Address - Zip Code:24378-2023
Practice Address - Country:US
Practice Address - Phone:276-398-2292
Practice Address - Fax:276-398-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)