Provider Demographics
NPI:1699234617
Name:TROJAN MEDICAL SUPPLY CORP
Entity type:Organization
Organization Name:TROJAN MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:SMITH III
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-378-5555
Mailing Address - Street 1:1320 SE FEDERAL HWY STE 208
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-3410
Mailing Address - Country:US
Mailing Address - Phone:772-320-9976
Mailing Address - Fax:
Practice Address - Street 1:1320 SE FEDERAL HWY STE 208
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-3410
Practice Address - Country:US
Practice Address - Phone:772-320-9976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-19
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies