Provider Demographics
NPI:1174844609
Name:TRUSTWAY TEAM SERVICES
Entity Type:Organization
Organization Name:TRUSTWAY TEAM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-952-0200
Mailing Address - Street 1:PO BOX 59275
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35259-9275
Mailing Address - Country:US
Mailing Address - Phone:334-434-0938
Mailing Address - Fax:404-835-4073
Practice Address - Street 1:UNIVERSITY OF MARYLAND 379 FIELD HOUSE DR
Practice Address - Street 2:GOSSETT FOOTBALL TEAM HOUSE
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20742-0001
Practice Address - Country:US
Practice Address - Phone:334-434-0938
Practice Address - Fax:404-835-4073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty