Provider Demographics
NPI:1619528031
Name:TRI-COUNTY RURAL HEALTH SERVICES
Entity Type:Organization
Organization Name:TRI-COUNTY RURAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLNATHA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:478-569-4443
Mailing Address - Street 1:407 LEONARD CIR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30830-1354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:639A VESTAL RD
Practice Address - Street 2:
Practice Address - City:SARDIS
Practice Address - State:GA
Practice Address - Zip Code:30456-2155
Practice Address - Country:US
Practice Address - Phone:478-569-4443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty