Provider Demographics
NPI:1427173822
Name:TRINITY MEDICAL CENTER
Entity type:Organization
Organization Name:TRINITY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGLIUZZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-779-2218
Mailing Address - Street 1:4469 48TH AVENUE CT
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-9213
Mailing Address - Country:US
Mailing Address - Phone:309-779-7020
Mailing Address - Fax:309-779-7005
Practice Address - Street 1:4469 48TH AVENUE CT
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-9213
Practice Address - Country:US
Practice Address - Phone:309-779-7020
Practice Address - Fax:309-779-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0901363Medicaid
IL140280Medicare PIN