Provider Demographics
NPI:1295972925
Name:TRI MEDICAL HOMECARE
Entity type:Organization
Organization Name:TRI MEDICAL HOMECARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED HOMEHEALTH ATTENDANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GETER
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:706-399-9092
Mailing Address - Street 1:4102 ELDERS DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-9133
Mailing Address - Country:US
Mailing Address - Phone:706-399-9092
Mailing Address - Fax:
Practice Address - Street 1:4102 ELDERS DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-9133
Practice Address - Country:US
Practice Address - Phone:706-399-9092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2009#037997251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health