Provider Demographics
NPI:1679771091
Name:TRI RIVERS SURGICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:TRI RIVERS SURGICAL ASSOCIATES, INC.
Other - Org Name:TRI RIVERS PHYSICAL MEDICINE & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKWITH
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:412-367-0600
Mailing Address - Street 1:9104 BABCOCK BLVD
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5818
Mailing Address - Country:US
Mailing Address - Phone:412-367-0600
Mailing Address - Fax:412-367-7079
Practice Address - Street 1:301 1ST ST
Practice Address - Street 2:SUITE 100
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4756
Practice Address - Country:US
Practice Address - Phone:724-287-1556
Practice Address - Fax:412-367-7079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006963180002Medicaid
PA0006963180002Medicaid