Provider Demographics
NPI:1730314832
Name:TRI-COUNTY NURSING LLC
Entity type:Organization
Organization Name:TRI-COUNTY NURSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:MILTIMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-257-9869
Mailing Address - Street 1:1250 N MOUNTAIN RD STE 312
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1795
Mailing Address - Country:US
Mailing Address - Phone:223-237-1051
Mailing Address - Fax:232-371-1052
Practice Address - Street 1:1250 N MOUNTAIN RD STE 312
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1795
Practice Address - Country:US
Practice Address - Phone:223-237-1051
Practice Address - Fax:223-237-1052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03590501251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023846350001Medicaid
PA3845616OtherENTITY NUMBER
PA398108OtherCMS CERTIFICATION NUMBER