Provider Demographics
NPI:1154073153
Name:TRUEAGLE ENTERPRISES, LLC
Entity Type:Organization
Organization Name:TRUEAGLE ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:DWIGHT
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-328-5041
Mailing Address - Street 1:PO BOX 377
Mailing Address - Street 2:
Mailing Address - City:CENTRE
Mailing Address - State:AL
Mailing Address - Zip Code:35960-0377
Mailing Address - Country:US
Mailing Address - Phone:256-328-5041
Mailing Address - Fax:888-823-9473
Practice Address - Street 1:162 COUNTY ROAD 317
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:AL
Practice Address - Zip Code:35983-3119
Practice Address - Country:US
Practice Address - Phone:256-328-5041
Practice Address - Fax:888-823-9373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies