Provider Demographics
NPI:1124346135
Name:TRIPLE DL, LTD
Entity type:Organization
Organization Name:TRIPLE DL, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:804-525-5120
Mailing Address - Street 1:4914 RADFORD AVE
Mailing Address - Street 2:STE 303
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3538
Mailing Address - Country:US
Mailing Address - Phone:804-525-5120
Mailing Address - Fax:804-525-5128
Practice Address - Street 1:4914 RADFORD AVE
Practice Address - Street 2:STE 303
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3538
Practice Address - Country:US
Practice Address - Phone:804-525-5120
Practice Address - Fax:804-525-5128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO10654251E00000X, 385H00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care