Provider Demographics
NPI:1184122491
Name:TRITIN MEDICAL DISTRIBUTION
Entity type:Organization
Organization Name:TRITIN MEDICAL DISTRIBUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF SURGICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-521-5528
Mailing Address - Street 1:112 N 8TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-2976
Mailing Address - Country:US
Mailing Address - Phone:469-247-3881
Mailing Address - Fax:888-750-6959
Practice Address - Street 1:9 MEDICAL PKWY STE 108
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-7868
Practice Address - Country:US
Practice Address - Phone:469-779-6070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies