OrganizationTriumph LlcCommunity/Behavioral HealthAgenciesPractice Address4000 Wake Forest Rd, Suite 200, Raleigh, NC 27609-6879(919) 852-5352(919) 256-0824PECOS EnrollmentBased on the most recent information from CMS, provider Triumph Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1841336021Provider TypeOrganizationFull NameTriumph LlcSubpartNoEnumeration Date1/29/2007Last Updated9/28/2012Contact InformationPractice LocationPractice Address4000 Wake Forest Rd, Suite 200, Raleigh, NC 27609-6879Phone(919) 852-5352Fax(919) 852-5323Mailing LocationMailing Address3210 Fairhill Dr, Raleigh, NC 27612-3215Phone(919) 256-0824Fax(919) 256-0833Authorized OfficialNameJones, Harold E (Member Mgr)Phone(919) 256-0824Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID8300782DescriptionMedicaidIssuerUnlistedNorth CarolinaID8300782BDescriptionMedicaidIssuerUnlistedNorth CarolinaID8300782GDescriptionMedicaidIssuerUnlistedNorth CarolinaID8300782HDescriptionMedicaidIssuerUnlistedNorth CarolinaID8300782QDescriptionMedicaidIssuerUnlistedNorth Carolina