TRI STATE UROLOGIC SERVICES PSC INC

Non-Pharmacy Dispensing Site

Code: 332900000X

Physician Assistant — Medical

Code: 363AM0700X

Nurse Practitioner — Acute Care

Code: 363LA2100X

Nurse Practitioner — Family

Code: 363LF0000X

Nurse Anesthetist, Certified Registered

Code: 367500000X

Urology

Code: 208800000X