Provider Demographics
NPI:1902407646
Name:TROUTMAN ENTERPRISES, LLC
Entity Type:Organization
Organization Name:TROUTMAN ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-593-2789
Mailing Address - Street 1:3344 E CARDINAL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-4859
Mailing Address - Country:US
Mailing Address - Phone:417-593-2789
Mailing Address - Fax:
Practice Address - Street 1:5337 S CAMPBELL AVE STE A2
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2494
Practice Address - Country:US
Practice Address - Phone:417-593-2789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST MEDICAL SUPPLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-07
Last Update Date:2020-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies