Provider Demographics
NPI:1932757325
Name:TRI-STATE HEALTH, INC
Entity Type:Organization
Organization Name:TRI-STATE HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMED
Authorized Official - Middle Name:ARIF
Authorized Official - Last Name:NIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-392-6408
Mailing Address - Street 1:PO BOX 1250
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21922-1250
Mailing Address - Country:US
Mailing Address - Phone:410-392-6408
Mailing Address - Fax:
Practice Address - Street 1:107 N BRIDGE ST
Practice Address - Street 2:UNITED STATES
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5326
Practice Address - Country:US
Practice Address - Phone:410-392-6408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-28
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty