Provider Demographics
NPI:1912022302
Name:TRINITY MEDICAL CENTER
Entity Type:Organization
Organization Name:TRINITY MEDICAL CENTER
Other - Org Name:TRINITY AT TERRACE PARK AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF HOSPITAL OPERATIO
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SPYROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-779-2329
Mailing Address - Street 1:8110 14TH ST W
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-7601
Mailing Address - Country:US
Mailing Address - Phone:309-787-2036
Mailing Address - Fax:309-787-3795
Practice Address - Street 1:4500 UTICA RIDGE RD
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-1626
Practice Address - Country:US
Practice Address - Phone:563-742-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0200329Medicaid
IA160104Medicare PIN