Provider Demographics
NPI:1124278460
Name:TRIANGLE LITHOTRIPSY CORPORATION
Entity type:Organization
Organization Name:TRIANGLE LITHOTRIPSY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRYANT
Authorized Official - Last Name:DRIGGS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:615-370-3366
Mailing Address - Street 1:7003 CHADWICK DR
Mailing Address - Street 2:SUITE 321
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5232
Mailing Address - Country:US
Mailing Address - Phone:615-370-3366
Mailing Address - Fax:615-371-1887
Practice Address - Street 1:2601 OBERLIN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27608-1319
Practice Address - Country:US
Practice Address - Phone:615-370-3366
Practice Address - Fax:615-371-1887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QL0400XAmbulatory Health Care FacilitiesClinic/CenterLithotripsy