Provider Demographics
NPI: | 1992096192 |
---|---|
Name: | TRINITY HOSPITAL TWIN CITY |
Entity type: | Organization |
Organization Name: | TRINITY HOSPITAL TWIN CITY |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | DWAYNE |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RICHARDSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSN, BSN, RN |
Authorized Official - Phone: | 740-922-7450 |
Mailing Address - Street 1: | 819 N 1ST ST |
Mailing Address - Street 2: | |
Mailing Address - City: | DENNISON |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 44621-1003 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 740-922-2800 |
Mailing Address - Fax: | 740-922-6945 |
Practice Address - Street 1: | 819 N 1ST ST |
Practice Address - Street 2: | |
Practice Address - City: | DENNISON |
Practice Address - State: | OH |
Practice Address - Zip Code: | 44621-1003 |
Practice Address - Country: | US |
Practice Address - Phone: | 740-922-2800 |
Practice Address - Fax: | 740-922-6945 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-04-22 |
Last Update Date: | 2023-09-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 282NC0060X | Hospitals | General Acute Care Hospital | Critical Access | Group - Multi-Specialty |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
No | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | Group - Multi-Specialty |
No | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | Group - Multi-Specialty |
No | 363LP0200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics | Group - Multi-Specialty |
No | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
OH | 36Z302 | Medicare PIN | |
OH | 361302 | Medicare PIN |