Provider Demographics
NPI:1447594395
Name:TRINITY MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:TRINITY MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:419-344-1134
Mailing Address - Street 1:425 JEFFERSON AVE
Mailing Address - Street 2:SUITE 620
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1060
Mailing Address - Country:US
Mailing Address - Phone:419-344-1134
Mailing Address - Fax:
Practice Address - Street 1:425 JEFFERSON AVE
Practice Address - Street 2:SUITE 620
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43604-1060
Practice Address - Country:US
Practice Address - Phone:419-344-1134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2150908332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies