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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1952462012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRI-STATE CENTERS FOR SIGHT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 631662
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-1662
Country	:	US
Telephone Number	:	859-581-7120
Fax Number	:	859-581-7207

Provider Business Practice Location Address
First Line	:	1017 MAIN ST
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-1605
Country	:	US
Telephone Number	:	513-868-2181
Fax Number	:	513-868-2893

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DANIEL A NORDLOH
Credential	:
Telephone Number	:	859-581-7120

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	03/03/2014

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