NPIMap

Organization Active NPI

Tug River Health Association, Inc.

  • Clinical Medical Laboratory
  • Welch, WV
National Provider Identifier
1548749062
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
51D1064007 Issued in WV
Legal business name
TUG RIVER HEALTH ASSOCIATION, INC.
Practice address
950 Mount View Rd
Welch, WV 24801-2810
Phone
(304) 448-2101
Fax
(304) 448-3217
NPI assigned
Aug 7, 2018
Last updated
Aug 7, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kim Harris
Title
Credentialing/Billing Coord.
Phone
(304) 448-2101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 51D1064007 WV Primary

Addresses

Primary practice location

950 Mount View Rd
Welch, WV 24801-2810

Mailing address

RR 103 Supply Street
PO Box 507
Gary, WV 24836
Phone (304) 448-2101

Other identifiers 1

IdentifierTypeStateIssuer
3810005540MedicaidWV

Other names 2

  • Tug River /Mt.View Wellness Center Other name
  • Tug River Health Association Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
51D1064007Tug River Mount View Wellness Center950 Mount View Road Suite 500, Welch, WV 24801Certificate of waiverJan 25, 2027

National Provider Directory

National Provider Directory
Tax ID family
Tug River Health Association Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

1880 Mount View Rd
Welch, WV 24801
Phone (304) 436-4798

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533600000000",
    "number": "1548749062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 103 SUPPLY STREET",
            "address_2": "PO BOX 507",
            "city": "GARY",
            "state": "WV",
            "postal_code": "24836",
            "telephone_number": "304-448-2101",
            "fax_number": "304-448-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 MOUNT VIEW RD",
            "city": "WELCH",
            "state": "WV",
            "postal_code": "248012810",
            "telephone_number": "304-448-2101",
            "fax_number": "304-448-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUG RIVER HEALTH ASSOCIATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-07",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "CREDENTIALING/BILLING COORD.",
        "authorized_official_telephone_number": "304-448-2101"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WV",
            "license": "51D1064007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005540",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tug River /Mt.View Wellness Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tug River Health Association",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Welch, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.