Provider Demographics
NPI:1285087288
Name:TRI STATE IMAGING SOLUTIONS LLC
Entity type:Organization
Organization Name:TRI STATE IMAGING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIPERVAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-967-1079
Mailing Address - Street 1:2840 PINE RD SUITE D1
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-4258
Mailing Address - Country:US
Mailing Address - Phone:215-967-1079
Mailing Address - Fax:215-967-1077
Practice Address - Street 1:2840 PINE RD SUITE D1
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-4258
Practice Address - Country:US
Practice Address - Phone:215-967-1079
Practice Address - Fax:215-967-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier