Provider Demographics
NPI:1245383017
Name:TRISTATE HOME HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:TRISTATE HOME HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELKEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BANSAH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:410-922-1200
Mailing Address - Street 1:5400 OLD COURT RD
Mailing Address - Street 2:SUITE # 304
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5100
Mailing Address - Country:US
Mailing Address - Phone:410-922-1200
Mailing Address - Fax:410-922-0280
Practice Address - Street 1:5400 OLD COURT RD
Practice Address - Street 2:SUITE # 304
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5100
Practice Address - Country:US
Practice Address - Phone:410-922-1200
Practice Address - Fax:410-922-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV9470010000251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care