Provider Demographics
NPI:1093715609
Name:TRIUMPH HOSPITAL OF NORTHWEST, LP
Entity Type:Organization
Organization Name:TRIUMPH HOSPITAL OF NORTHWEST, LP
Other - Org Name:TRIUMPH HOSPITAL NORTHWEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP COMPLIANCE AND QUALITY
Authorized Official - Prefix:MS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:LANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:RN MBA
Authorized Official - Phone:713-807-8686
Mailing Address - Street 1:7333 NORTH FWY STE 500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1322
Mailing Address - Country:US
Mailing Address - Phone:713-807-8686
Mailing Address - Fax:713-807-8604
Practice Address - Street 1:205 HOLLOW TREE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2801
Practice Address - Country:US
Practice Address - Phone:713-807-8686
Practice Address - Fax:713-807-8604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007926282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157708201Medicaid
TXHH1024OtherBLUE CROSS
452081Medicare Oscar/Certification