MEDICARE: TRI-STATE CENTERS FOR SIGHT INC

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	261QS0132X	Ophthalmologic Surgery Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	490002965	OTHER		MEDICARE RAILROAD

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

General Provider Information

NPI Number	:	1871698894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-STATE CENTERS FOR SIGHT INC

Provider Business Mailing Address
First Line	:	2865 CHANCELLOR DR STE 215
Second Line	:
City	:	CRESTVIEW HILLS
State	:	KY
Zip	:	41017-3931
Country	:	US
Telephone Number	:	859-331-1058
Fax Number	:	513-791-4567

Provider Business Practice Location Address
First Line	:	8044 MONTGOMERY RD
Second Line	:	SUITE 155
City	:	CINCINNATI
State	:	OH
Zip	:	45236-2919
Country	:	US
Telephone Number	:	513-936-3734
Fax Number	:	513-791-1473

Authorized Official
Title or Position	:	CHIEF REVENUE CYCLE OFFICER
Name	:	CANDICE B DAVIS
Credential	:
Telephone Number	:	916-990-7590

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	09/11/2025

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Directions to “TRI-STATE CENTERS FOR SIGHT INC ” Practice Location

Language	Start Address	Practice Location

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