Provider Demographics
NPI:1265423016
Name:TRI-STATE SURGICAL ASSISTANTS, LLC
Entity type:Organization
Organization Name:TRI-STATE SURGICAL ASSISTANTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:FLAGG
Authorized Official - Suffix:II
Authorized Official - Credentials:CSA
Authorized Official - Phone:240-403-4067
Mailing Address - Street 1:1 RESEARCH CT
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3221
Mailing Address - Country:US
Mailing Address - Phone:240-403-4067
Mailing Address - Fax:301-519-8001
Practice Address - Street 1:1 RESEARCH CT
Practice Address - Street 2:SUITE 450
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3221
Practice Address - Country:US
Practice Address - Phone:240-403-4067
Practice Address - Fax:301-519-8001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty