Organization
TRI STATE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LEIGH ANN YUNGMANN (GENERAL MANAGER)
(419) 337-2399
Entity
Organization
Contact information
Practice address
732 S SHOOP AVE, WAUSEON, OH 43567-1707
(419) 337-2399
(419) 337-5392
Mailing address
732 S SHOOP AVE, P.O. BOX 251, WAUSEON, OH 43567-1707
(419) 337-2399
(419) 337-5392
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
02-0873800
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0469818
—
OH
Enumeration date
06/30/2005
Last updated
08/11/2016
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