Provider Demographics
NPI:1598829996
Name:TRILINE PRODUCTS, LLC
Entity Type:Organization
Organization Name:TRILINE PRODUCTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-779-7250
Mailing Address - Street 1:7027 HAYVENHURST AVENUE
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91360
Mailing Address - Country:US
Mailing Address - Phone:818-779-7250
Mailing Address - Fax:818-455-0654
Practice Address - Street 1:7027 HAYVENHURST AVE
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3802
Practice Address - Country:US
Practice Address - Phone:818-779-7250
Practice Address - Fax:818-455-0654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADME 02529FMedicaid