MEDICARE: TRI-STATE MRI PTR

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	261QM1200X	Magnetic Resonance Imaging (MRI) Clinic/Center

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760489256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-STATE MRI PTR

Provider Business Mailing Address
First Line	:	PO BOX 494
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25709-0494
Country	:	US
Telephone Number	:	304-522-6674
Fax Number	:	304-522-4647

Provider Business Practice Location Address
First Line	:	1802 6TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25703-1519
Country	:	US
Telephone Number	:	304-522-6674
Fax Number	:	304-522-4647

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	MS. MARY ALICE ROBERTS
Credential	:
Telephone Number	:	304-522-6674

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	06/23/2008

Similar Medicare Providers

1366535478 — SUSAN L COYER LSW, CCAC,NAADAC
Practice Location Address:

1420 WASHINGTON AVE
HUNTINGTON, WV
25704-1519

Practice Phone: 304-525-7851
Practice Fax: 304-525-1073

1982769550 — VOCA CORPORATION OF WEST VIRGINIA, INC.
Practice Location Address:

1519 8TH AVE
HUNTINGTON, WV
25701-2923

Practice Phone: 304-523-0177
Practice Fax: 304-523-0178

1437274263 — GENISE LYNN LALOS LSW, CAC
Practice Location Address:

1420 WASHINGTON AVE
HUNTINGTON, WV
25704-1519

Practice Phone: 304-525-7851
Practice Fax: 304-697-1286

1871259580 — REM WV, INC
Practice Location Address:

1519 8TH AVE
HUNTINGTON, WV
25701-2923

Practice Phone: 304-233-3474
Practice Fax:

1720913239 — JOHN PRENTICE PSY.D
Practice Location Address:

2585 3RD AVE
HUNTINGTON, WV
25703-1642

Practice Phone: 304-781-5138
Practice Fax:

1578533345 — AMANDA K BENNETT MD
Practice Location Address:

2585 3RD AVENUE
HUNTINGTON, WV
25703

Practice Phone: 304-781-5138
Practice Fax:

Directions to “TRI-STATE MRI PTR ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.