MEDICARE: TRIO COMMUNITY MEALS, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	332U00000X	Home Delivered Meals	MS
2	332U00000X	Home Delivered Meals	AL
3	332U00000X	Home Delivered Meals	MI
4	332U00000X	Home Delivered Meals	TX
5	332U00000X	Home Delivered Meals	OH

General Provider Information

NPI Number	:	1477983252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIO COMMUNITY MEALS, LLC

Provider Business Mailing Address
First Line	:	100 VALLEY DRIVE
Second Line	:
City	:	PEARL
State	:	MS
Zip	:	39208
Country	:	US
Telephone Number	:	844-773-0370
Fax Number	:	601-664-3356

Provider Business Practice Location Address
First Line	:	2120 GARDEN LAKE PARKWAY
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614
Country	:	US
Telephone Number	:	419-382-5791
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT, TRIO COMMUNITY MEALS, LL
Name	:	MR. JOHN KIRK
Credential	:
Telephone Number	:	601-664-3221

Provider Enumeration Date	:	11/15/2013
Last Update Date	:	11/22/2024

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