Provider Demographics
NPI:1871698894
Name:TRI-STATE CENTERS FOR SIGHT INC
Entity type:Organization
Organization Name:TRI-STATE CENTERS FOR SIGHT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF REVENUE CYCLE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-990-7590
Mailing Address - Street 1:2865 CHANCELLOR DR STE 215
Mailing Address - Street 2:
Mailing Address - City:CRESTVIEW HILLS
Mailing Address - State:KY
Mailing Address - Zip Code:41017-3931
Mailing Address - Country:US
Mailing Address - Phone:859-331-1058
Mailing Address - Fax:513-791-4567
Practice Address - Street 1:8044 MONTGOMERY RD
Practice Address - Street 2:SUITE 155
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-2919
Practice Address - Country:US
Practice Address - Phone:513-936-3734
Practice Address - Fax:513-791-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0648204Medicaid
OH3112223Medicaid
KY36000321Medicaid
490002965OtherMEDICARE RAILROAD
OH3610101Medicare PIN