Provider Demographics
NPI:1053411173
Name:TRI-COUNTY MEDICAL SERVICES, INC.
Entity type:Organization
Organization Name:TRI-COUNTY MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:.PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:300-877-6613
Mailing Address - Street 1:855 W MAPLE ST
Mailing Address - Street 2:STE 120
Mailing Address - City:HARTVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44632-9668
Mailing Address - Country:US
Mailing Address - Phone:330-877-6613
Mailing Address - Fax:330-877-6618
Practice Address - Street 1:855 W MAPLE ST
Practice Address - Street 2:STE 120
Practice Address - City:HARTVILLE
Practice Address - State:OH
Practice Address - Zip Code:44632-9668
Practice Address - Country:US
Practice Address - Phone:330-877-6613
Practice Address - Fax:330-877-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0202050001Medicare NSC