Tridentcare
LBN: Kan-Di-Ki Llc
Tridentcare is an health care organization with primary practice located at 17744 Ne San Rafael St , Portland OR 97230-5927. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Ultrasound, Suppliers / Portable X-ray and/or Other Portable Diagnostic Imaging Supplier. Allopathic & Osteopathic Physicians / Diagnostic Ultrasound is the primary health care specialty.
Kan-Di-Ki Llc can be contacted via phone (800) 638-3240, or through Cuomo, Brian C via phone (800) 786-8015.
Contact Information
Primary practice address
17744 Ne San Rafael St
Portland OR 97230-5927
Phone: (800) 638-3240
Fax: (303) 576-7986
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | ||
| Suppliers / Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 335V00000X |
Profile Details
| NPI number | 1083926612 |
|---|---|
| LBN Legal business name | Kan-Di-Ki Llc |
| DBA Doing business as | Tridentcare |
| Authorized official | Cuomo, Brian C |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 12th, 2010 |
| Last updated | Feb 7th, 2024 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083926612 | NPPES |
| Oregon | MEDICAID | 500654573 | |
| Oregon | Other | P01099725 |
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