Provider Demographics
NPI:1245972504
Name:TRI-COUNTY FAMILY MEDICINE PROGRAM, INC.
Entity type:Organization
Organization Name:TRI-COUNTY FAMILY MEDICINE PROGRAM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-519-1575
Mailing Address - Street 1:PO BOX 601
Mailing Address - Street 2:
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-0601
Mailing Address - Country:US
Mailing Address - Phone:585-335-3100
Mailing Address - Fax:
Practice Address - Street 1:60 RED JACKET ST STE 8
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-1758
Practice Address - Country:US
Practice Address - Phone:585-432-2398
Practice Address - Fax:585-432-2399
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI-COUNTY FAMILY MEDICINE PROGRAM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-08
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy