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General NPI Number Information
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NPI Number | 1467834267
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Entity Type | Organization
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Legal Business Name | TRI-STATE MOBILITY, LLC
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 11/23/2020
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Provider Practice Location Address
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Address Line | 712 WINCHESTER AVE
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City | ASHLAND
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State | KY
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Zip | 41101-7443
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Country | US
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Telephone | 606-329-1344
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Fax | 606-329-0207
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Provider Business Mailing Address
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Address Line | 712 WINCHESTER AVE
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City | ASHLAND
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State | KY
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Zip | 41101-7443
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Country | US
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Telephone | 606-329-1344
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Fax | 606-329-0207
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Authorized Official
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Title or Position | OWNER, SOLE MEMBER
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Name | STEVEN LYON
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Credential |
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Telephone | 606-329-1344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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