Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
TRI-STATE MEDICAL GROUP, INC.
Active
Organization
TRI-STATE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN F. MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
100 CHIPPEWA TOWN CTR., HERITAGE VALLEY CONVENIENT CARE-BEAVER FALLS, BEAVER FALLS, PA 15010
(724) 774-2942
(724) 774-5175
Mailing address
1000 DUTCH RIDGE ROAD C-4, HERITAGE VALLEY BEAVER CREDENTIALING, BEAVER, PA 15009
(724) 773-4776
(724) 773-4726
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014950830029
—
PA
05
—
0015654460023
—
PA
05
—
1007289980010
—
PA
Enumeration date
06/16/2009
Last updated
06/18/2009
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up