Provider Demographics
NPI:1205239522
Name:EUGENE B TRIPLET II
Entity type:Organization
Organization Name:EUGENE B TRIPLET II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING HOME ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:TRIPLET
Authorized Official - Suffix:II
Authorized Official - Credentials:LNHA
Authorized Official - Phone:757-201-0281
Mailing Address - Street 1:1824 N STREAMLINE DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-4433
Mailing Address - Country:US
Mailing Address - Phone:757-201-0281
Mailing Address - Fax:
Practice Address - Street 1:1824 N STREAMLINE DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-4433
Practice Address - Country:US
Practice Address - Phone:757-201-0281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1701002695251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health