NPIMap

Organization Active NPI

Tri Area Community Health

Doing business as Tri-Area Community Pharmacy at Laurel Fork

  • Community/Retail Pharmacy
  • Laurel Fork, VA
National Provider Identifier
1780647461
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TRI AREA COMMUNITY HEALTH
Doing business as
Tri-Area Community Pharmacy at Laurel Fork
Practice address
14558 Danville Pike
Laurel Fork, VA 24352-3758
Phone
(276) 398-2854
Fax
(276) 398-3331
NPI assigned
Apr 11, 2006
Last updated
Jul 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Authorized official

Name
James Werth Jr., PH.D
Title
Ceo
Phone
(276) 398-2292

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

14558 Danville Pike
Laurel Fork, VA 24352-3758

Mailing address

PO Box 9
Laurel Fork, VA 24352-0009
Phone (276) 398-2292

Other names 1

  • Tri-Area Community Pharmacy at Laurel Fork Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211110000039 VA Part B Supplier - Pharmacy 6204748296 1 other NPI on this enrollment
Practice locations: Fries, VA; Laurel Fork, VA

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Tri Area Community HealthFries, VA, CCN 491010 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Dec 7, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721865600000",
    "number": "1780647461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "LAUREL FORK",
            "state": "VA",
            "postal_code": "243520009",
            "telephone_number": "276-398-2292",
            "fax_number": "276-398-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14558 DANVILLE PIKE",
            "city": "LAUREL FORK",
            "state": "VA",
            "postal_code": "243523758",
            "telephone_number": "276-398-2854",
            "fax_number": "276-398-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI AREA COMMUNITY HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-11",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A",
        "authorized_official_last_name": "WERTH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "276-398-2292",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-Area Community Pharmacy at Laurel Fork",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel Fork, VA

Sources for this page

Verify at the official NPI Registry.