Provider Demographics
NPI: | 1255794194 |
---|---|
Name: | TRIUMPH THERAPEUTICS LLC |
Entity type: | Organization |
Organization Name: | TRIUMPH THERAPEUTICS LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | OMOLOLU |
Authorized Official - Middle Name: | OLUWATOSIN |
Authorized Official - Last Name: | MAJEKODUNMI |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTR/L |
Authorized Official - Phone: | 240-339-4976 |
Mailing Address - Street 1: | 1710 W VIRGINIA AVE NE UNIT 101 |
Mailing Address - Street 2: | |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20002-2338 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-739-1861 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4900 MASSACHUSETTS AVE NW STE 340 |
Practice Address - Street 2: | |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20016-4358 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-794-6820 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-03-29 |
Last Update Date: | 2023-12-15 |
Deactivation Date: | 2019-07-23 |
Deactivation Code: | |
Reactivation Date: | 2019-07-26 |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Single Specialty | |
Yes | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | Group - Multi-Specialty |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | Group - Multi-Specialty |
No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | Group - Multi-Specialty | |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | Group - Multi-Specialty | |
No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | Group - Multi-Specialty |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 224Y00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Clinical Exercise Physiologist | Group - Multi-Specialty | |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty |