1700246857 NPI number — TRINITY ALLIED HEALTH SOLUTIONS

Table of content: (NPI 1700246857)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700246857 NPI number — TRINITY ALLIED HEALTH SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINITY ALLIED HEALTH SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700246857
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 750103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEMPHIS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
38175-0103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2838 HICKORY HILL RD STE 30
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38115-2161
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-567-7444
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MONTAGUE
Authorized Official First Name:
YAVETTE
Authorized Official Middle Name:
Authorized Official Title or Position:
CO-FOUNDER
Authorized Official Telephone Number:
901-567-7444

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  142811 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 7247 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: A810629 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)