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NPI Code Detail

MEDICARE: TRI STATE HOME CARE SERVICES, LLC

MEDICARE: TRI STATE HOME CARE SERVICES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043763907
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI STATE HOME CARE SERVICES, LLC
Provider Business Mailing Address
First Line : PO BOX 17
Second Line :
City : FORT ASHBY
State : WV
Zip : 26719-0017
Country : US
Telephone Number : 304-298-3434
Fax Number :
Provider Business Practice Location Address
First Line : 128 PRESIDENTS ST
Second Line :
City : FORT ASHBY
State : WV
Zip : 26719-0017
Country : US
Telephone Number : 558-813-1332
Fax Number : 304-298-3435
Authorized Official
Title or Position : OWNER
Name : DONALD KYLE HARRIS II
Credential :
Telephone Number : 855-813-1332
Provider Enumeration Date : 07/27/2016
Last Update Date : 09/11/2025

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Directions to “TRI STATE HOME CARE SERVICES, LLC ” Practice Location

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