Provider Demographics
NPI:1336101120
Name:TRI, P.A.
Entity Type:Organization
Organization Name:TRI, P.A.
Other - Org Name:THERAPEUTIC RADIOLOGISTS INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:KOEPKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-313-2677
Mailing Address - Street 1:3841 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:KS
Mailing Address - Zip Code:66208-1713
Mailing Address - Country:US
Mailing Address - Phone:816-313-2677
Mailing Address - Fax:816-313-6000
Practice Address - Street 1:3841 W 64TH ST
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:KS
Practice Address - Zip Code:66208-1713
Practice Address - Country:US
Practice Address - Phone:816-313-2677
Practice Address - Fax:816-313-6000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS4220000BMedicare PIN
MO4220000AMedicare PIN