Provider Demographics
NPI:1376842609
Name:TYCON MEDICAL SYSTEMS, INC
Entity Type:Organization
Organization Name:TYCON MEDICAL SYSTEMS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:C
Authorized Official - Last Name:TRAPANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-640-1709
Mailing Address - Street 1:801 ORAPAX ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1323
Mailing Address - Country:US
Mailing Address - Phone:757-640-1709
Mailing Address - Fax:
Practice Address - Street 1:334 EFFINGHAM ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-2306
Practice Address - Country:US
Practice Address - Phone:757-393-2273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0206009540332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1002810002OtherNCS PTAN