Provider Demographics
NPI:1205923901
Name:TRINITY MEDICAL SUPPLIES L.L.C.
Entity type:Organization
Organization Name:TRINITY MEDICAL SUPPLIES L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLEVELAND
Authorized Official - Middle Name:GLYNN
Authorized Official - Last Name:MICHAUD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:337-457-9277
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-0326
Mailing Address - Country:US
Mailing Address - Phone:337-684-0318
Mailing Address - Fax:337-684-0462
Practice Address - Street 1:190 ST MATTHEW DRIVE
Practice Address - Street 2:
Practice Address - City:CHURCH POINT
Practice Address - State:LA
Practice Address - Zip Code:70525
Practice Address - Country:US
Practice Address - Phone:337-684-0318
Practice Address - Fax:337-684-0462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1119741Medicaid
LA5383690001Medicare NSC