Provider Demographics
NPI:1609326040
Name:TRISTAR FAMILY CARE, LLC
Entity Type:Organization
Organization Name:TRISTAR FAMILY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GROUP VP/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-373-7630
Mailing Address - Street 1:313 N MAIN ST FL 2
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-1347
Mailing Address - Country:US
Mailing Address - Phone:615-792-1911
Mailing Address - Fax:
Practice Address - Street 1:313 N MAIN ST FL 2
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1347
Practice Address - Country:US
Practice Address - Phone:615-792-1911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty