Healthcare Provider Details
I. General information
NPI: 1225360159
Provider Name (Legal Business Name): TRI-STATE CENTERS FOR SIGHT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/03/2010
Last Update Date: 03/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7730 MONTGOMERY RD SUITE 130
CINCINNATI OH
45236-4283
US
IV. Provider business mailing address
2865 CHANCELLOR DR SUITE 215
CRESTVIEW HILLS KY
41017-3912
US
V. Phone/Fax
- Phone: 513-936-5044
- Fax: 513-891-0543
- Phone: 859-344-2079
- Fax: 859-581-7207
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 156FX1800X |
| Taxonomy | Optician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JACALYN
C
BARBERY
Title or Position: ADMINISTRATOR
Credential:
Phone: 859-344-2062