Tri County Medical Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

TRI COUNTY MEDICAL CENTER, INC

Doing business as

Tri County Community Health Clinic

Practice address

County Road 49
Lower Peach Tree, AL 36751

Phone

(334) 636-2925

NPI assigned

Sep 23, 2008

Last updated

Sep 24, 2008By the provider in NPPES

Organization subpart

Yes

Parent organization

TRI COUNTY MEDICAL CENTER, INCAs reported in NPPES

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

Authorized official

Name

Marilyn J Sawyer

Title

Executive Director

Phone

(251) 578-1163

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tri County Community Health Clinic Doing business as

Part of

Tri-County Med Ctr Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Tri County Medical Center Inc

  • Internal Medicine Physician
  • Evergreen, AL
  • NPI 1679658371
  NPPES parent name

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

{
    "created_epoch": "1222128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1740430107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 726",
            "city": "EVERGREEN",
            "state": "AL",
            "postal_code": "364010726",
            "telephone_number": "251-578-1163",
            "fax_number": "251-578-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COUNTY ROAD 49",
            "city": "LOWER PEACH TREE",
            "state": "AL",
            "postal_code": "36751",
            "telephone_number": "334-636-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI COUNTY MEDICAL CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRI COUNTY MEDICAL CENTER, INC",
        "enumeration_date": "2008-09-23",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "SAWYER",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "251-578-1163"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "01D0867799",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri County Community Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.