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General NPI Number Information
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NPI Number | 1720364938
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Entity Type | Organization
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Legal Business Name | TRINITY HOME MEDICAL INC
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Dates
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Enumeration Date | 11/01/2011
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Last Update Date | 11/01/2011
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Provider Practice Location Address
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Address Line | 9500 W LINCOLN HWY UNIT 5
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City | FRANKFORT
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State | IL
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Zip | 60423-1940
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Country | US
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Telephone | 708-341-7116
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Fax | 815-277-2456
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Provider Business Mailing Address
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Address Line | 11450 TEA TREE LN
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City | FRANKFORT
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State | IL
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Zip | 60423-5102
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Country | US
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Telephone | 815-534-5724
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Fax | 815-277-2456
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Authorized Official
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Title or Position | PRESIDENT
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Name | NADIRAH MATOUK
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Credential |
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Telephone | 815-534-5724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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