| Tri-county Psychiatric Services, Llc | |
|
557 Glover Ave Suite 1 Enterprise AL 36330-2024 | |
| (334) 347-7705 | |
| (334) 347-7715 |
| Full Name | Tri-county Psychiatric Services, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 557 Glover Ave, Enterprise, Alabama |
| Authorized Official Name and Position | Eyob Hailu Tessema (SOLE OWNER) |
| Authorized Official Contact | 3343477705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-county Psychiatric Services, Llc 557 Glover Ave Suite 1 Enterprise AL 36330-2024 Ph: (334) 347-7705 | Tri-county Psychiatric Services, Llc 557 Glover Ave Suite 1 Enterprise AL 36330-2024 Ph: (334) 347-7705 |
| NPI Number | 1467706879 |
|---|---|
| Provider Enumeration Date | 11/07/2012 |
| Last Update Date | 11/07/2012 |
| Medicare PECOS PAC ID | 9133372154 |
|---|---|
| Medicare Enrollment ID | O20121226000264 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467706879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (Alabama) | Primary |
| Provider Name | Eyob H Tessema |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639195076 PECOS PAC ID: 1759330699 Enrollment ID: I20050118000456 |
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