MEDICARE: TRIUMPH HOSPICE

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	251G00000X	Community Based Hospice Care Agency	009926	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	009926	OTHER	TX	DEPT.AGING&DISABILITY SVS

General Provider Information

NPI Number	:	1710053855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIUMPH HOSPICE

Provider Business Mailing Address
First Line	:	17000 PRESTON RD
Second Line	:	SUITE 350
City	:	DALLAS
State	:	TX
Zip	:	75248-1224
Country	:	US
Telephone Number	:	972-447-0211
Fax Number	:	972-692-8767

Provider Business Practice Location Address
First Line	:	17000 PRESTON RD
Second Line	:	SUITE 350
City	:	DALLAS
State	:	TX
Zip	:	75248-1224
Country	:	US
Telephone Number	:	972-447-0211
Fax Number	:	972-692-8767

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHANIE NICHOLS
Credential	:	RN
Telephone Number	:	972-447-0211

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	08/22/2020

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Directions to “TRIUMPH HOSPICE ” Practice Location

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