Provider Demographics
NPI:1215380514
Name:TRINITY FORCE LLC
Entity Type:Organization
Organization Name:TRINITY FORCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHISEMA
Authorized Official - Middle Name:ASFAW
Authorized Official - Last Name:KERAGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-284-6223
Mailing Address - Street 1:340 N 5TH AVE
Mailing Address - Street 2:APT 506
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-4507
Mailing Address - Country:US
Mailing Address - Phone:602-284-6223
Mailing Address - Fax:
Practice Address - Street 1:340 N 5TH AVE
Practice Address - Street 2:APT 506
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85003-4507
Practice Address - Country:US
Practice Address - Phone:602-284-6223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)