MEDICARE: TRINITY HEALTHCARE SERVICES LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1790396844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	622B OLD EASLEY HWY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-6521
Country	:	US
Telephone Number	:	864-910-0892
Fax Number	:	864-552-1151

Provider Business Practice Location Address
First Line	:	622B OLD EASLEY HWY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29611-6521
Country	:	US
Telephone Number	:	864-910-0892
Fax Number	:	864-552-1151

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LASHONDA BURT-REEDER
Credential	:
Telephone Number	:	864-910-0892

Provider Enumeration Date	:	08/12/2020
Last Update Date	:	08/12/2020

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Directions to “TRINITY HEALTHCARE SERVICES LLC ” Practice Location

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