Healthcare Provider Details

I. General information

NPI: 1639652159
Provider Name (Legal Business Name): TRINITY CARDIOLOGY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 CHESTERFIELD AVE STE 300
CHARLESTON WV
25304-1066
US

IV. Provider business mailing address

2335 CHESTERFIELD AVE STE 300
CHARLESTON WV
25304-1066
US

V. Phone/Fax

Practice location:
  • Phone: 681-265-3820
  • Fax: 681-265-5031
Mailing address:
  • Phone: 681-265-3820
  • Fax: 681-265-5031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. SRINIVASAN NARASIMHAN
Title or Position: OWNER
Credential: MD
Phone: 681-265-3820