Provider Demographics
NPI:1740319011
Name:TRI 3 ENTERPRISES, LLC
Entity type:Organization
Organization Name:TRI 3 ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-307-5236
Mailing Address - Street 1:950 N RAND RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:WAUCONDA
Mailing Address - State:IL
Mailing Address - Zip Code:60084-1197
Mailing Address - Country:US
Mailing Address - Phone:888-847-6903
Mailing Address - Fax:847-526-3379
Practice Address - Street 1:2346 S LYNHURST DR
Practice Address - Street 2:SUITE 501
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-8621
Practice Address - Country:US
Practice Address - Phone:317-248-3916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5937430001Medicare NSC