Provider Demographics
NPI:1801980024
Name:TRI-MED, INC.
Entity type:Organization
Organization Name:TRI-MED, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:JED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-323-8280
Mailing Address - Street 1:39011 HARPER AVE.
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP.
Mailing Address - State:MI
Mailing Address - Zip Code:48036
Mailing Address - Country:US
Mailing Address - Phone:586-323-8280
Mailing Address - Fax:586-323-8283
Practice Address - Street 1:39011 HARPER AVE.
Practice Address - Street 2:
Practice Address - City:CLINTON TWP.
Practice Address - State:MI
Practice Address - Zip Code:48036
Practice Address - Country:US
Practice Address - Phone:586-323-8280
Practice Address - Fax:586-323-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301006991251F00000X, 332B00000X, 332BP3500X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E00024OtherBLUE CARE NETWORK
MI2631401Medicaid
MI0P45110OtherMEDICARE B WPS
MI540E00477OtherBCBS MI DME
MI470E00024OtherBCBS MI HIT
MI=========OtherCOMMERCIAL
MI0E00024OtherBLUE CARE NETWORK