Provider Demographics
NPI:1598991739
Name:TRILOGY HEALTHCARE
Entity Type:Organization
Organization Name:TRILOGY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-542-0022
Mailing Address - Street 1:1876 CRAIGSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63146-4006
Mailing Address - Country:US
Mailing Address - Phone:314-542-0022
Mailing Address - Fax:314-317-9357
Practice Address - Street 1:1876 CRAIGSHIRE RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-4006
Practice Address - Country:US
Practice Address - Phone:314-542-0022
Practice Address - Fax:314-317-9357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO7583HH251E00000X
251F00000X, 335E00000X
5312350001332B00000X, 332BP3500X, 332BX2000X
MO20040208063336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO7583HHOtherSTATE LICENSE HOME HEALTH
MO7583HHOtherSTATE LICENSE HOME HEALTH
MO267588Medicare Oscar/Certification