Provider Demographics
NPI:1770668790
Name:TRIUMPH HEALTH CARE, INC.
Entity Type:Organization
Organization Name:TRIUMPH HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVIS
Authorized Official - Middle Name:
Authorized Official - Last Name:OKPAMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-401-6140
Mailing Address - Street 1:1800 MARTIN LUTHER KING PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3500
Mailing Address - Country:US
Mailing Address - Phone:919-401-6140
Mailing Address - Fax:919-401-6142
Practice Address - Street 1:1800 MARTIN LUTHER KING PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-3500
Practice Address - Country:US
Practice Address - Phone:919-401-6140
Practice Address - Fax:919-401-6142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2386251E00000X
NCNP2864251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3409673Medicaid
NC6600947Medicaid