Provider Demographics
NPI:1992014211
Name:TRINITY SENIOR HOME HEALTH
Entity type:Organization
Organization Name:TRINITY SENIOR HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORRETTA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:MCMILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-747-6890
Mailing Address - Street 1:442 LIVINGSTON TER
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-3224
Mailing Address - Country:US
Mailing Address - Phone:803-937-5931
Mailing Address - Fax:803-937-5932
Practice Address - Street 1:442 LIVINGSTON TER
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-3224
Practice Address - Country:US
Practice Address - Phone:803-937-5931
Practice Address - Fax:803-937-5932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care