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General NPI Number Information
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NPI Number | 1417907395
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Entity Type | Organization
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Legal Business Name | DOCTORS HOME VISITS OF THE TRIAD, PC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4035 UNIVERSITY PKWY SUITE 100
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City | WINSTON-SALEM
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State | NC
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Zip | 27106-3325
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Country | US
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Telephone | 336-896-0826
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Fax | 336-896-2038
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Provider Business Mailing Address
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Address Line | 11100 MEAD RD SUITE 300
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City | BATON ROUGE
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State | LA
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Zip | 70816-2260
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Country | US
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Telephone | 225-295-3548
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Fax | 225-295-9678
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. HENRY F. TRIPP
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Credential | M.D.
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Telephone | 336-896-0826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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