MEDICARE: TRINORA ALLEN

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	251E00000X	Home Health Agency		VA

General Provider Information

NPI Number	:	1477012003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINORA ALLEN

Provider Business Mailing Address
First Line	:	4718 TWIN HICKORY LAKE DR
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-2588
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4718 TWIN HICKORY LAKE DR
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-2588
Country	:	US
Telephone Number	:	804-617-4211
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2019
Last Update Date	:	03/13/2019

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Directions to “ TRINORA ALLEN ” Practice Location

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