Provider Demographics
NPI:1144225707
Name:TRITRAX HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:TRITRAX HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-469-8340
Mailing Address - Street 1:2261 BROOKHOLLOW PLAZA DR
Mailing Address - Street 2:STE 106
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-7417
Mailing Address - Country:US
Mailing Address - Phone:817-469-8340
Mailing Address - Fax:817-469-8341
Practice Address - Street 1:2261 BROOKHOLLOW PLAZA DR
Practice Address - Street 2:STE 106
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7417
Practice Address - Country:US
Practice Address - Phone:817-469-8340
Practice Address - Fax:817-469-8341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009004251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453166Medicare ID - Type Unspecified