{"npi":"1609348325","type":"NPI-2","status":"active","name":{"display":"Tri-State Health, Inc.","other":[],"organization_name":"TRI-STATE HEALTH, INC.","authorised_official":"Muhammed Niaz"},"specialty":{"primary_taxonomy":"291U00000X","primary_taxonomy_description":"Clinical Medical Laboratory","slug":"clinical-medical-laboratory","schema_org_specialty":"Pathology","all":[{"code":"291U00000X","description":"Clinical Medical Laboratory","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"107 N BRIDGE ST","city":"ELKTON","state":"MD","postal_code":"219215326","country_code":"US","phone":"4103926408","fax":"4103926409"},{"purpose":"MAILING","street_1":"107 N BRIDGE ST","city":"ELKTON","state":"MD","postal_code":"219215326","country_code":"US","phone":"4103926408","fax":"4103926409"}],"license":null,"identifiers":[{"type_code":"05","label":"Medicaid","value":"558904500","state":"MD","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20200406001534","type_code":"12-69","type_desc":"PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY","state":"MD","pac_id":"0143328153"}]},"enumeration_date":"2018-12-19","last_updated":"2024-02-05","_meta":{"source":"NPPES","snapshot_date":"2024-02-05","doc_url":"https://findmynpi.com/api"}}