Provider Demographics
NPI:1083890164
Name:TRINITY HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:TRINITY HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:910-640-0856
Mailing Address - Street 1:1424 S JK POWELL BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-9167
Mailing Address - Country:US
Mailing Address - Phone:910-640-0856
Mailing Address - Fax:910-640-0858
Practice Address - Street 1:1424 S JK POWELL BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-9167
Practice Address - Country:US
Practice Address - Phone:910-640-0856
Practice Address - Fax:910-640-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2963251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3418055Medicaid