Provider Demographics
NPI:1568012185
Name:TROJAN MEDICAL SUPPLIES & EQUIPMENT, INC
Entity Type:Organization
Organization Name:TROJAN MEDICAL SUPPLIES & EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NUBIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:AVALOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-635-6404
Mailing Address - Street 1:150 E SAMPLE RD STE 210
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-3350
Mailing Address - Country:US
Mailing Address - Phone:561-635-6404
Mailing Address - Fax:
Practice Address - Street 1:150 E SAMPLE RD STE 210
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-3350
Practice Address - Country:US
Practice Address - Phone:561-635-6404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-16
Last Update Date:2019-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies