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General NPI Number Information
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NPI Number | 1407804784
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Entity Type | Organization
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Legal Business Name | TRINITY MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16601 BLANCO RD
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1914
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Country | US
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Telephone | 210-764-8106
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Fax |
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Provider Business Mailing Address
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Address Line | 16601 BLANCO RD
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City | SAN ANTONIO
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State | TX
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Zip | 78232-1938
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Country | US
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Telephone | 210-764-8106
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASON CHEATHAM
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Credential |
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Telephone | 210-764-8106
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0085654
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License Number State | TX
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