Provider Demographics
NPI:1225399983
Name:TRINITY HOME CARE
Entity Type:Organization
Organization Name:TRINITY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:580-571-4305
Mailing Address - Street 1:5101 HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-9237
Mailing Address - Country:US
Mailing Address - Phone:580-571-4305
Mailing Address - Fax:866-591-9698
Practice Address - Street 1:5101 HUNTER RD
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-9237
Practice Address - Country:US
Practice Address - Phone:580-571-4305
Practice Address - Fax:866-591-9698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care