Provider Demographics
NPI:1851824643
Name:TRI-STATE ORTHOPEDIC SALES
Entity Type:Organization
Organization Name:TRI-STATE ORTHOPEDIC SALES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:FRENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-613-5483
Mailing Address - Street 1:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:MI
Mailing Address - Zip Code:49242-0835
Mailing Address - Country:US
Mailing Address - Phone:313-613-5483
Mailing Address - Fax:
Practice Address - Street 1:867 29 MILE RD
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:MI
Practice Address - Zip Code:49245-9513
Practice Address - Country:US
Practice Address - Phone:313-613-5483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies