Organization
TRI-STATE MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA GAY ANDERSON COF (PRESIDENT)
(606) 783-7053
Entity
Organization
Contact information
Practice address
271 E. MAIN STREET, MOREHEAD, KY 40351
(606) 783-7053
(606) 783-7058
Mailing address
271 E. MAIN STREET, MOREHEAD, KY 40351
(606) 783-7053
(606) 783-7058
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
02/12/2008
Last updated
11/05/2008
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