Provider Demographics
NPI:1275779241
Name:TRIO MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:TRIO MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:AIYEOJENKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-343-9700
Mailing Address - Street 1:9550 FOREST LN STE 207
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6099
Mailing Address - Country:US
Mailing Address - Phone:214-343-9700
Mailing Address - Fax:866-904-2927
Practice Address - Street 1:9550 FOREST LN STE 207
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6099
Practice Address - Country:US
Practice Address - Phone:214-343-9700
Practice Address - Fax:866-904-2927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6249370001Medicare NSC