Provider Demographics
NPI:1083785620
Name:TRIANGLE THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:TRIANGLE THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BENGE
Authorized Official - Suffix:
Authorized Official - Credentials:OTR L
Authorized Official - Phone:937-456-6505
Mailing Address - Street 1:911 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-9520
Mailing Address - Country:US
Mailing Address - Phone:937-456-6505
Mailing Address - Fax:937-456-6507
Practice Address - Street 1:911 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-9520
Practice Address - Country:US
Practice Address - Phone:937-456-6505
Practice Address - Fax:937-456-6507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT 071302251P0200X
OHOT 001485225XP0200X
OHOT 006768225XP0200X
OHSP 7428235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000342662OtherANTHEM BLUE CROSS AND BLU