Provider Demographics
NPI:1730255118
Name:TRI-COUNTY OCCUPANTIONAL MEDICINE PC
Entity type:Organization
Organization Name:TRI-COUNTY OCCUPANTIONAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:STROH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-925-6050
Mailing Address - Street 1:505 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:YOUNGWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:15697-1529
Mailing Address - Country:US
Mailing Address - Phone:724-925-6050
Mailing Address - Fax:724-925-1690
Practice Address - Street 1:505 N 4TH ST
Practice Address - Street 2:
Practice Address - City:YOUNGWOOD
Practice Address - State:PA
Practice Address - Zip Code:15697-1529
Practice Address - Country:US
Practice Address - Phone:724-925-6050
Practice Address - Fax:724-925-1690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022940E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA085221Medicare PIN