Organization
TRI-STATE SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TROY DALE FOSTER D.O. (MEDICAL DIRECTOR/PARTNER)
(304) 267-0556
Entity
Organization
Contact information
Practice address
1006 TAVERN RD, MARTINSBURG, WV 25401-2864
(304) 267-0556
Mailing address
1006 TAVERN RD, MARTINSBURG, WV 25401-2864
(304) 267-0556
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
19418-23067
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6905041000
—
WV
Enumeration date
11/02/2006
Last updated
07/09/2020
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