Provider Demographics
NPI:1184472078
Name:TRILOVE DIABETIC AND MEDICAL COMMODITIES LLC
Entity type:Organization
Organization Name:TRILOVE DIABETIC AND MEDICAL COMMODITIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETRONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:CERTIFIED SHOEFITTER
Authorized Official - Phone:478-419-1440
Mailing Address - Street 1:PO BOX 112
Mailing Address - Street 2:
Mailing Address - City:SWAINSBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30401-0112
Mailing Address - Country:US
Mailing Address - Phone:478-149-1439
Mailing Address - Fax:877-428-6576
Practice Address - Street 1:303 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:SWAINSBORO
Practice Address - State:GA
Practice Address - Zip Code:30401-3613
Practice Address - Country:US
Practice Address - Phone:478-419-1439
Practice Address - Fax:877-428-6576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies