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General NPI Number Information
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NPI Number | 1669879151
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Entity Type | Organization
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Legal Business Name | TRI-STATE CENTERS FOR SIGHT, INC
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Dates
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Enumeration Date | 11/26/2014
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Last Update Date | 03/30/2016
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Provider Practice Location Address
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Address Line | 4452 EASTGATE BLVD SUITE 305
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City | CINCINNATI
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State | OH
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Zip | 45245-1584
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Country | US
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Telephone | 859-581-7120
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Fax | 859-581-7207
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Provider Business Mailing Address
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Address Line | 2865 CHANCELLOR DR SUITE 215
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3912
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Country | US
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Telephone | 859-344-2079
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Fax | 859-581-7207
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JACKIE C BARBERY
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Credential |
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Telephone | 859-344-2062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | OH
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