Provider Demographics
NPI:1770680985
Name:TRICOUNTY MEDICAL EQUIPMENT AND SUPPLY,LLC
Entity type:Organization
Organization Name:TRICOUNTY MEDICAL EQUIPMENT AND SUPPLY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-206-0040
Mailing Address - Street 1:122 MILL RD
Mailing Address - Street 2:SUITE A130
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-1409
Mailing Address - Country:US
Mailing Address - Phone:610-630-6357
Mailing Address - Fax:610-630-8319
Practice Address - Street 1:278 GRANITE RUN DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6804
Practice Address - Country:US
Practice Address - Phone:717-560-4025
Practice Address - Fax:717-560-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007735180017Medicaid
PA1281160009Medicare NSC
PA1007735180017Medicaid