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General NPI Number Information
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NPI Number | 1396261426
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Entity Type | Organization
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Legal Business Name | TRIPLE A SUPPLIES, INC
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 08/21/2017
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Provider Practice Location Address
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Address Line | 50 JEANNE DRIVE
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City | NEWBURGH
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State | NY
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Zip | 12550-7634
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Country | US
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Telephone | 845-926-3340
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Fax | 845-926-3347
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Provider Business Mailing Address
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Address Line | 50 JEANNE DRIVE
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City | NEWBURGH
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State | NY
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Zip | 12550-7634
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Country | US
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Telephone | 845-926-3340
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Fax | 945-926-3347
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MS. TONJA ALEXANDRA WERKMAN
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Credential | MS, R.D.N
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Telephone | 732-267-0490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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