Provider Demographics
NPI:1497848709
Name:TRIPP CHIROPRACTIC & NUTRITION INC.
Entity Type:Organization
Organization Name:TRIPP CHIROPRACTIC & NUTRITION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRIPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-342-5503
Mailing Address - Street 1:2160 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2728
Mailing Address - Country:US
Mailing Address - Phone:724-342-5503
Mailing Address - Fax:724-342-5990
Practice Address - Street 1:2160 E STATE ST
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2728
Practice Address - Country:US
Practice Address - Phone:724-342-5503
Practice Address - Fax:724-342-5990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008724111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA158438100OtherOWCP
PA224556OtherHEALTH ASSURANCE
PA0019531240001Medicaid
PA325563OtherUPMC HEALTH
PATR1459509OtherBLUE CROSS BLUE SHIELD
PAP00217405OtherRAILROAD MEDICARE
PA158438100OtherOWCP
PATR1459509OtherBLUE CROSS BLUE SHIELD