Provider Demographics
NPI:1043234677
Name:TRINITY WEST
Entity Type:Organization
Organization Name:TRINITY WEST
Other - Org Name:TRINITY FAMILY CARE CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:WERKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-264-8110
Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7608
Practice Address - Street 1:380 SUMMIT AVE
Practice Address - Street 2:MSO PHYSICIAN BILLING
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2667
Practice Address - Country:US
Practice Address - Phone:740-283-7597
Practice Address - Fax:740-283-7807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2218880Medicaid
OHCD8015OtherMEDICARE TRAVELERS
PA000834530 0003Medicaid
OH0236033Medicaid
OH2052479Medicaid
PA000834530 0003Medicaid
PA233458Medicare PIN
OH2218880Medicaid
OH9313111Medicare PIN
OH0236033Medicaid