Healthcare Provider Details

I. General information

NPI: 1801719869
Provider Name (Legal Business Name): TRI-STATE CENTERS FOR SIGHT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W MARTIN LUTHER KING BLVD
DANVILLE KY
40422-2037
US

IV. Provider business mailing address

500 ROSS ST STE 154-0455
PITTSBURGH PA
15262-0001
US

V. Phone/Fax

Practice location:
  • Phone: 859-236-6055
  • Fax:
Mailing address:
  • Phone: 859-331-1058
  • Fax: 513-791-4567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State

VIII. Authorized Official

Name: CANDICE B DAVIS
Title or Position: CHIEF REVENUE CYCLE OFFICER
Credential:
Phone: 916-990-7590