Organization
TRI STATE MEDICAL GROUP, INC
Active
Other names
Heritage Valley Nursing Practice
Organization subpart
No
Provider details
NPI number
Authorized official
NORMAN F MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
918 3RD AVE, BEAVER FALLS, PA 15010-4613
(724) 773-8895
Mailing address
918 3RD AVE, BEAVER FALLS, PA 15010-4613
(724) 773-8895
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
OS010098L
PA
314000000X
Skilled Nursing Facility
OS010098L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017867880011
—
PA
Enumeration date
01/22/2009
Last updated
01/22/2009
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