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General NPI Number Information
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NPI Number | 1740723733
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Entity Type | Organization
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Legal Business Name | TRI-COUNTY NURSING, LLC
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 426 MAIN ST
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City | BROCKWAY
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State | PA
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Zip | 15824-1325
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Country | US
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Telephone | 814-265-0011
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Fax | 814-265-0015
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Provider Business Mailing Address
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Address Line | 426 MAIN ST
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City | BROCKWAY
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State | PA
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Zip | 15824-1325
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Country | US
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Telephone | 814-265-0011
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Fax | 814-265-0015
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Authorized Official
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Title or Position | OWNER
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Name | MRS. PATRICIA DIANE REDMOND
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Credential |
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Telephone | 814-265-0011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | 03590501
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 03590501
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 03590501
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License Number State | PA
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