Provider Demographics
NPI:1053345744
Name:TRIUMPH MEDICAL SUPPLY SERVICES
Entity type:Organization
Organization Name:TRIUMPH MEDICAL SUPPLY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:O
Authorized Official - Last Name:NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-326-5252
Mailing Address - Street 1:1090 VERMONT AVE NW
Mailing Address - Street 2:SUITE 820
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-4905
Mailing Address - Country:US
Mailing Address - Phone:202-326-5252
Mailing Address - Fax:202-408-4701
Practice Address - Street 1:1090 VERMONT AVE NW
Practice Address - Street 2:SUITE 820
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-4905
Practice Address - Country:US
Practice Address - Phone:202-326-5252
Practice Address - Fax:202-408-4701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC5635580001Medicare NSC