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General NPI Number Information
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NPI Number | 1285684423
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Entity Type | Organization
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Legal Business Name | TRINITY MEDICAL CENTER
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 4469 48TH AVENUE CT
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City | ROCK ISLAND
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State | IL
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Zip | 61201-9213
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Country | US
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Telephone | 309-779-7020
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Fax | 309-787-3795
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Provider Business Mailing Address
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Address Line | 4469 48TH AVENUE CT
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City | ROCK ISLAND
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State | IL
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Zip | 61201-9213
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Country | US
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Telephone | 309-779-7020
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Fax | 309-787-3795
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Authorized Official
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Title or Position | CFO
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Name | MR. GREGORY PAGLIUZZA
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Credential |
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Telephone | 309-779-2218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2001000
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 22978
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 22978
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License Number State | IL
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