Healthcare Provider Details

I. General information

NPI: 1467637421
Provider Name (Legal Business Name): TRI-COUNTY MEDICAL SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 02/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 W MAPLE ST STE 120
HARTVILLE OH
44632-9668
US

IV. Provider business mailing address

855 W MAPLE ST STE 120
HARTVILLE OH
44632-9668
US

V. Phone/Fax

Practice location:
  • Phone: 330-877-6613
  • Fax: 330-877-6618
Mailing address:
  • Phone: 330-877-6613
  • Fax: 330-877-6618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateOH

VIII. Authorized Official

Name: DR. JEAN A LANG
Title or Position: OWNER
Credential: D.O.
Phone: 330-877-6613