Provider Demographics
NPI:1225360159
Name:TRI-STATE CENTERS FOR SIGHT, INC.
Entity Type:Organization
Organization Name:TRI-STATE CENTERS FOR SIGHT, INC.
Other - Org Name:TRI-STATE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACALYN
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARBERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-344-2062
Mailing Address - Street 1:2865 CHANCELLOR DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3912
Mailing Address - Country:US
Mailing Address - Phone:859-344-2079
Mailing Address - Fax:859-581-7207
Practice Address - Street 1:7730 MONTGOMERY RD
Practice Address - Street 2:SUITE 130
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-4283
Practice Address - Country:US
Practice Address - Phone:513-936-5044
Practice Address - Fax:513-891-0543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-03
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1117880011Medicare NSC