1790713048 NPI number — TRINITY HOME HEALTH SERVICES

Table of content: (NPI 1790713048)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790713048 NPI number — TRINITY HOME HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRINITY HOME HEALTH SERVICES
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:
SAINT JOSEPH VNA HOME CARE
Provider Other Organization Name Type Code:
3
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:
1790713048
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9185
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGTON HILLS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48333-9185
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-542-8213
Provider Business Mailing Address Fax Number:
734-542-8282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
810 PARK PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MISHAWAKA
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46545-3520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
574-472-6500
Provider Business Practice Location Address Fax Number:
574-472-6501
Provider Enumeration Date:
06/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BISHOP
Authorized Official First Name:
ERIN
Authorized Official Middle Name:
S
Authorized Official Title or Position:
DIRECTOR OF PATIENT ACCOUNTING
Authorized Official Telephone Number:
734-542-8213

Provider Taxonomy Codes

  • Taxonomy code: 374700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 200502900A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".




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