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General NPI Number Information
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NPI Number | 1548339807
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Entity Type | Individual
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Provider Name | CARMINE TRINGOLO RN, CRNFA
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 858 CLEVELAND HILL RD
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City | ROSEBURG
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State | OR
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Zip | 97470-9614
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Country | US
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Telephone | 541-672-4398
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 W HARVARD AVE PMB 5205
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City | ROSEBURG
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State | OR
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Zip | 97470-2923
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Country | US
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Telephone | 541-672-4398
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number |
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License Number State | OR
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