MEDICARE: TRINITY HEALTH SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency	HC 3035	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407024086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	1008 BULLARD CT
Second Line	:	SUITE 203
City	:	RALEIGH
State	:	NC
Zip	:	27615-6833
Country	:	US
Telephone Number	:	919-877-8633
Fax Number	:	919-877-8996

Provider Business Practice Location Address
First Line	:	409 W MAIN ST
Second Line	:	SUITE 203
City	:	WASHINGTON
State	:	NC
Zip	:	27889-4882
Country	:	US
Telephone Number	:	252-946-4100
Fax Number	:	252-946-4121

Authorized Official
Title or Position	:	DIRECTOR/CEO
Name	:	MRS. REGINA WILLIAMS HARRELL
Credential	:
Telephone Number	:	919-877-8633

Provider Enumeration Date	:	02/15/2008
Last Update Date	:	07/07/2009

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Directions to “TRINITY HEALTH SERVICES, INC. ” Practice Location

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