Healthcare Provider Details
I. General information
NPI: 1134895006
Provider Name (Legal Business Name): THH ACQUISITION LLC I
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/19/2021
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
675 TOLLGATE RD STE P
ELGIN IL
60123-9352
US
IV. Provider business mailing address
555 E NORTH LN STE 5075
CONSHOHOCKEN PA
19428-2490
US
V. Phone/Fax
- Phone: 847-213-9224
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BP3500X |
| Taxonomy | Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WENDY
RUSSALESI
Title or Position: CCO
Credential:
Phone: 484-246-9499