Provider Demographics
NPI:1093982902
Name:TRIMBOLI BOGIE INC PC
Entity Type:Organization
Organization Name:TRIMBOLI BOGIE INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRIMBOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-836-8890
Mailing Address - Street 1:706 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321-1612
Mailing Address - Country:US
Mailing Address - Phone:219-836-8890
Mailing Address - Fax:219-836-2344
Practice Address - Street 1:706 RIDGE RD
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1612
Practice Address - Country:US
Practice Address - Phone:219-836-8890
Practice Address - Fax:219-836-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001441A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN404850Medicare PIN
INU38165Medicare UPIN