Provider Demographics
NPI:1669927083
Name:T3 MEDICAL
Entity type:Organization
Organization Name:T3 MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:BROERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-430-5751
Mailing Address - Street 1:9855 DOUBLE R BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-6027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9855 DOUBLE R BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-6027
Practice Address - Country:US
Practice Address - Phone:561-430-5751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-16
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies