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NPI Code Detail

MEDICARE: TRINITY MEDICAL CENTER

MEDICARE: TRINITY MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13416L0300XLand Ambulance2001000IA
2343900000XNon-emergency Medical Transport (VAN)22978IL
33416L0300XLand Ambulance22978IL

General Provider Information

NPI Number : 1285684423
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRINITY MEDICAL CENTER
Provider Business Mailing Address
First Line : 4469 48TH AVENUE CT
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-9213
Country : US
Telephone Number : 309-779-7020
Fax Number : 309-787-3795
Provider Business Practice Location Address
First Line : 4469 48TH AVENUE CT
Second Line :
City : ROCK ISLAND
State : IL
Zip : 61201-9213
Country : US
Telephone Number : 309-779-7020
Fax Number : 309-787-3795
Authorized Official
Title or Position : CFO
Name : MR. GREGORY PAGLIUZZA
Credential :
Telephone Number : 309-779-2218
Provider Enumeration Date : 05/10/2006
Last Update Date : 11/18/2009

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Practice Location Address:
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1427367333 — KRISTA THANOS-KNAPP MOT, OTR/L
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Practice Fax:
1487192415 — KERRY M MCCRACKEN BS,OTR/L
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1891211348 — STEPHANIE LYNN PHARES MOT,OTR/L
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1194363747 — JAMES MATSON PT, DPT
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Directions to “TRINITY MEDICAL CENTER ” Practice Location

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