| Triumph Llc | |
|
189 Samaritan Ridge Road Elkin NC 28621 | |
| (336) 526-8335 | |
| Not Available |
| Full Name | Triumph Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 189 Samaritan Ridge Road, Elkin, North Carolina |
| Authorized Official Name and Position | Paul Caldwell (CEO) |
| Authorized Official Contact | 9194672433 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Triumph Llc 189 Samaritan Ridge Road Elkin NC 28621 Ph: (336) 526-8335 | Triumph Llc 189 Samaritan Ridge Road Elkin NC 28621 Ph: (336) 526-8335 |
| NPI Number | 1174675441 |
|---|---|
| Provider Enumeration Date | 01/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174675441 | NPI | - | NPPES |
| 8300779H | Medicaid | NC | |
| 8300779 | Medicaid | NC | |
| 8300779G | Medicaid | NC | |
| 8300779B | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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