Tri - State Medical Group, Inc.

NPI #1720129943 in Midland, Pennsylvania

Provider Information

NPI Number
1720129943
Entity Type
Organization
Organization Name
Tri - State Medical Group, Inc.
Subpart
Yes (part of a larger organization)
Parent Organization
MEDVANTX, INC
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Feb 9, 2007
Last Updated
Oct 17, 2012

Practice Location

Address
21 7TH ST
ZIP Code
15059-1452
Phone
(724) 643-4852

Authorized Official

Name
KENNY HEINE
Title
DIRECTOR OF OPERATIONS
Phone
(858) 625-2990

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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