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General NPI Number Information
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NPI Number | 1912316431
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Entity Type | Organization
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Legal Business Name | TRI-STATE POWER SUPPLY
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Dates
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Enumeration Date | 08/08/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 48 DOUGHTY RD
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City | LAWRENCEBURG
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State | IN
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Zip | 47025-2939
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Country | US
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Telephone | 812-537-2500
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Fax | 812-537-2501
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Provider Business Mailing Address
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Address Line | 48 DOUGHTY RD
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City | LAWRENCEBURG
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State | IN
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Zip | 47025-2939
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Country | US
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Telephone | 812-537-2500
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Fax | 812-537-2501
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Authorized Official
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Title or Position | PARTNER
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Name | MR. TERRY W MILLER
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Credential | MED
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Telephone | 812-537-2500
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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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