Provider Demographics
NPI:1821180324
Name:CSRA HOLDINGS LLC
Entity Type:Organization
Organization Name:CSRA HOLDINGS LLC
Other - Org Name:TRINITY HOME HEALTH (MASTECTOMY CARE)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, BUSINESS OFFICE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-465-7466
Mailing Address - Street 1:2260 WRIGHTSBORO RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-4764
Mailing Address - Country:US
Mailing Address - Phone:706-729-6000
Mailing Address - Fax:706-729-6451
Practice Address - Street 1:2803 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-3913
Practice Address - Country:US
Practice Address - Phone:706-729-6000
Practice Address - Fax:706-729-6451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA5796220002Medicare NSC