Provider Demographics
NPI:1750731360
Name:TRIUMPH HEALTH SERVICES
Entity type:Organization
Organization Name:TRIUMPH HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TREMAINE
Authorized Official - Middle Name:RONEIL
Authorized Official - Last Name:RAE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:980-219-1479
Mailing Address - Street 1:2750 E WT HARRIS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4285
Mailing Address - Country:US
Mailing Address - Phone:980-505-6148
Mailing Address - Fax:
Practice Address - Street 1:2750 E WT HARRIS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4285
Practice Address - Country:US
Practice Address - Phone:980-505-6148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC4831251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health