MEDICARE: TRINITY ASSISTANCE GROUP, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	341600000X	Ambulance
2	347E00000X	Transportation Broker
3	3416A0800X	Air Ambulance

General Provider Information

NPI Number	:	1700357977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY ASSISTANCE GROUP, LLC

Provider Business Mailing Address
First Line	:	4317 EL MAR DR
Second Line	:
City	:	LAUDERDALE BY THE SEA
State	:	FL
Zip	:	33308-5019
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 GALT OCEAN DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6833
Country	:	US
Telephone Number	:	954-771-7911
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	INGER LISA SKRODER
Credential	:
Telephone Number	:	954-771-7911

Provider Enumeration Date	:	12/16/2018
Last Update Date	:	12/16/2018

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