Provider Demographics
NPI:1407024086
Name:TRINITY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:TRINITY HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:WILLIAMS
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-877-8633
Mailing Address - Street 1:1008 BULLARD CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6833
Mailing Address - Country:US
Mailing Address - Phone:919-877-8633
Mailing Address - Fax:919-877-8996
Practice Address - Street 1:409 W MAIN ST
Practice Address - Street 2:SUITE 203
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4882
Practice Address - Country:US
Practice Address - Phone:252-946-4100
Practice Address - Fax:252-946-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC 3035251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601759Medicaid