Provider Demographics
NPI:1932365095
Name:TRI COUNTY COMMUNITY HEALTH COUNCIL INC
Entity Type:Organization
Organization Name:TRI COUNTY COMMUNITY HEALTH COUNCIL INC
Other - Org Name:COMMWELL HEALTH OF COLUMBUS COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-567-6194
Mailing Address - Street 1:PO BOX 227
Mailing Address - Street 2:
Mailing Address - City:NEWTON GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28366-0227
Mailing Address - Country:US
Mailing Address - Phone:910-567-6194
Mailing Address - Fax:910-567-4389
Practice Address - Street 1:209 W VIRGIL ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-4017
Practice Address - Country:US
Practice Address - Phone:910-641-0202
Practice Address - Fax:910-641-0208
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI-COUNTY COMMUNITY HEALTH COUNCIL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-29
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)