Healthcare Provider Details

I. General information

NPI: 1790385276
Provider Name (Legal Business Name): TRUMEDIS HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 W WASHINGTON ST
HAGERSTOWN MD
21740-5211
US

IV. Provider business mailing address

1019 W WASHINGTON ST
HAGERSTOWN MD
21740-5211
US

V. Phone/Fax

Practice location:
  • Phone: 443-247-3001
  • Fax: 443-247-3003
Mailing address:
  • Phone: 443-247-3001
  • Fax: 443-247-3003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LANDRY DEUBOUE
Title or Position: OWNER
Credential:
Phone: 862-241-0099