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General NPI Number Information
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NPI Number | 1770966863
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Entity Type | Organization
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Legal Business Name | TRITON SUPPLY
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 6855 S KYRENE RD STE 101
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City | TEMPE
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State | AZ
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Zip | 85283-5455
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Country | US
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Telephone | 480-795-7955
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Fax | 602-428-6841
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Provider Business Mailing Address
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Address Line | 7227 E BASELINE RD STE 126
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City | MESA
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State | AZ
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Zip | 85209-5006
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Country | US
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Telephone | 480-795-7955
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Fax | 602-428-6841
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Authorized Official
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Title or Position | OWNER-MANAGER
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Name | MR. TYLER PACE
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Credential |
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Telephone | 480-795-7955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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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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