Healthcare Provider Details

I. General information

NPI: 1528225760
Provider Name (Legal Business Name): TRINITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 3RD ST
MOLINE IL
61265-6106
US

IV. Provider business mailing address

2701 17TH ST
ROCK ISLAND IL
61201-5351
US

V. Phone/Fax

Practice location:
  • Phone: 309-779-2031
  • Fax:
Mailing address:
  • Phone: 309-779-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number1813322
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number1813322
License Number StateIL

VIII. Authorized Official

Name: MS. FLORENCE L SPYROW
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 309-779-2219