Provider Demographics
NPI:1326376435
Name:TRINITY HOME DIALYSIS INC.
Entity Type:Organization
Organization Name:TRINITY HOME DIALYSIS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-824-5307
Mailing Address - Street 1:1414 W WHEATLAND RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4200
Mailing Address - Country:US
Mailing Address - Phone:972-824-5307
Mailing Address - Fax:972-709-1949
Practice Address - Street 1:1414 W WHEATLAND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4200
Practice Address - Country:US
Practice Address - Phone:972-824-5307
Practice Address - Fax:972-709-1949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment