| Triumph Llc | |
|
189 Samaritan Ridge Road Elkin NC 28621-2452 | |
| (336) 526-8335 | |
| Not Available |
| Full Name | Triumph Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 189 Samaritan Ridge Road, Elkin, North Carolina |
| Authorized Official Name and Position | Brenda Frazier (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Contact | 9192560824 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Triumph Llc 189 Samaritan Ridge Road Elkin NC 28621-2452 Ph: (336) 526-8335 | Triumph Llc 189 Samaritan Ridge Road Elkin NC 28621-2452 Ph: (336) 526-8335 |
| NPI Number | 1972659704 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 07/24/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972659704 | NPI | - | NPPES |
| 5902796 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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