Healthcare Provider Details

I. General information

NPI: 1316047632
Provider Name (Legal Business Name): TRINITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 17TH ST
ROCK ISLAND IL
61201-5351
US

IV. Provider business mailing address

2701 17TH ST
ROCK ISLAND IL
61201-5351
US

V. Phone/Fax

Practice location:
  • Phone: 309-779-5000
  • Fax: 309-779-3209
Mailing address:
  • Phone: 309-779-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number0003244
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number1745008
License Number StateIL
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0003244
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0003244
License Number StateIL

VIII. Authorized Official

Name: MR. SHAWN MORROW
Title or Position: PRESIDENT
Credential:
Phone: 309-779-2200