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Contact Information

TRISTATE RURAL HEALTH CLINIC
20757 RIVERSIDE DR
GRUNDY, VA24614-6746
 Phone: 276-935-6424
 Fax: 276-935-2494
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for TRISTATE RURAL HEALTH CLINIC

NPI Number 1568622868
LBN Legal business name TRISTATE RURAL HEALTH CLINIC
Authorized official JANET STACY - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/11/2008
Last updated 06/11/2008 - About 18 years ago
Identifiers
VA License # 0101031664
VA Medicaid 006091750
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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