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:
Health care specialties
Specialty | Code | License # | 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 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1356706774 | NPPES |
Other | 615056800 | DOL | |
MEDICAID | 079972 | DOL |
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