Provider Demographics
NPI:1285926550
Name:TRINITY AMBULANCE TRANSPORT, LLC
Entity type:Organization
Organization Name:TRINITY AMBULANCE TRANSPORT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:MORA
Authorized Official - Last Name:TRIGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-227-4555
Mailing Address - Street 1:805 E JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1128
Mailing Address - Country:US
Mailing Address - Phone:956-227-4555
Mailing Address - Fax:956-686-2013
Practice Address - Street 1:818 S HWY 281
Practice Address - Street 2:
Practice Address - City:FALFURRIAS
Practice Address - State:TX
Practice Address - Zip Code:78355
Practice Address - Country:US
Practice Address - Phone:956-227-4555
Practice Address - Fax:956-686-2013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10006143416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3320335-01Medicaid
TX269921Medicare PIN