Healthcare Provider Details

I. General information

NPI: 1023179926
Provider Name (Legal Business Name): TRI-STATE CENTERS FOR SIGHT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8780 US HIGHWAY 42
FLORENCE KY
41042-8850
US

IV. Provider business mailing address

PO BOX 631662
CINCINNATI OH
45263-1662
US

V. Phone/Fax

Practice location:
  • Phone: 859-384-7058
  • Fax: 859-384-7427
Mailing address:
  • Phone: 859-581-7120
  • Fax: 859-581-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL A NORDLOH
Title or Position: ADMINISTRATOR
Credential:
Phone: 859-581-7120