Tristate Pain Institute

LBN: Tristate Medical Specialists Llc
Tristate Pain Institute is an health care organization with primary practice located at 1987 Mcculloch Blvd N , Lake Havasu City AZ 86403-5682. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Allopathic & Osteopathic Physicians / Pain Medicine is the primary health care specialty. Tristate Medical Specialists Llc can be contacted via phone (928) 788-3333, or through Venger, Joann via phone (928) 788-3333.

Contact Information

Primary practice address
1987 Mcculloch Blvd N Lake Havasu City AZ 86403-5682
Phone: (928) 788-3333
Fax: (928) 788-3555
Website:
Map and Directions
Authorized official contact:
Name: Venger, Joann
Phone: (928) 788-3333

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 20605 Arizona
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 20605 Arizona
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP3760 Arizona

Profile Details

NPI number 1356706774
LBN Legal business name Tristate Medical Specialists Llc
DBA Doing business as Tristate Pain Institute
Authorized official Venger, Joann
Entity Organization
Organization subpart 1 No
Enumeration date Dec 30th, 2015
Last updated Jul 19th, 2022 - about 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356706774 NPPES
Other 615056800 DOL
MEDICAID 079972 DOL

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