Provider Demographics
NPI:1619070059
Name:TRI COUNTY MEDICAL PRACTICE, LLC
Entity Type:Organization
Organization Name:TRI COUNTY MEDICAL PRACTICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:K
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-929-6560
Mailing Address - Street 1:307 C FINLEY RD
Mailing Address - Street 2:
Mailing Address - City:BELLE VERNON
Mailing Address - State:PA
Mailing Address - Zip Code:15012-1965
Mailing Address - Country:US
Mailing Address - Phone:724-929-6560
Mailing Address - Fax:724-929-6557
Practice Address - Street 1:307 FINLEY RD # C
Practice Address - Street 2:
Practice Address - City:BELLE VERNON
Practice Address - State:PA
Practice Address - Zip Code:15012-1965
Practice Address - Country:US
Practice Address - Phone:724-929-6560
Practice Address - Fax:724-929-6557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty