Provider Demographics
NPI:1114309614
Name:TRI-STATE COMMUNITY HEALTH CORPORATION
Entity Type:Organization
Organization Name:TRI-STATE COMMUNITY HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:PAULA
Authorized Official - Last Name:MCKAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN MSN
Authorized Official - Phone:215-760-4835
Mailing Address - Street 1:8841 KENBROOK CV
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7657
Mailing Address - Country:US
Mailing Address - Phone:215-760-4835
Mailing Address - Fax:
Practice Address - Street 1:8841 KENBROOK CV
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7657
Practice Address - Country:US
Practice Address - Phone:215-760-4835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)