Provider Demographics
NPI:1407533912
Name:TRIUMPH HEALTHCARE & SUPPORT SERVICES LLC
Entity Type:Organization
Organization Name:TRIUMPH HEALTHCARE & SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADEBANKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNWUMI
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN
Authorized Official - Phone:443-924-9155
Mailing Address - Street 1:5850 WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1941
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5850 WATERLOO RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1941
Practice Address - Country:US
Practice Address - Phone:443-924-9155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care