Provider Demographics
NPI:1043274103
Name:TRINITY MEDICAL SUPPLY AND NURSING SERVICE
Entity Type:Organization
Organization Name:TRINITY MEDICAL SUPPLY AND NURSING SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IZU
Authorized Official - Middle Name:
Authorized Official - Last Name:MBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-723-5900
Mailing Address - Street 1:7600 GEORGIA AVE NW
Mailing Address - Street 2:220
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1616
Mailing Address - Country:US
Mailing Address - Phone:202-723-5900
Mailing Address - Fax:
Practice Address - Street 1:7600 GEORGIA AVE NW
Practice Address - Street 2:220
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1616
Practice Address - Country:US
Practice Address - Phone:202-723-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC4969300001Medicare NSC