Provider Demographics
NPI:1679542419
Name:TRI-COUNTY OUTPATIENT SURGICAL FACILITY, INC.
Entity Type:Organization
Organization Name:TRI-COUNTY OUTPATIENT SURGICAL FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:FALCON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:724-226-3900
Mailing Address - Street 1:2913 FREEPORT RD
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065
Mailing Address - Country:US
Mailing Address - Phone:724-226-3900
Mailing Address - Fax:724-224-4004
Practice Address - Street 1:2913 FREEPORT RD
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065
Practice Address - Country:US
Practice Address - Phone:724-226-3900
Practice Address - Fax:724-224-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA04501500208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1152OtherHIGHMARK
PA300417Medicare ID - Type Unspecified