MEDICARE: TRI STATE MEDICAL

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
1	332BX2000X	Oxygen Equipment & Supplies (DME)		WV

Other Identifiers

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

General Provider Information

NPI Number	:	1720084304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI STATE MEDICAL

Provider Business Mailing Address
First Line	:	3924 MAIN STREET
Second Line	:
City	:	WEIRTON
State	:	WV
Zip	:	26062
Country	:	US
Telephone Number	:	304-797-8746
Fax Number	:	304-797-8752

Provider Business Practice Location Address
First Line	:	3924 MAIN ST
Second Line	:
City	:	WEIRTON
State	:	WV
Zip	:	26062-5314
Country	:	US
Telephone Number	:	304-797-8746
Fax Number	:	304-797-8752

Authorized Official
Title or Position	:	OWNER
Name	:	MR. JOHN JOSEPH BERNABEI
Credential	:	RPH
Telephone Number	:	304-723-6331

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	11/03/2025

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Directions to “TRI STATE MEDICAL ” Practice Location

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