Triton Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

TRITON SUPPLY

Practice address

3831 E Blue Lupine Dr Ste B2
Wasilla, AK 99654-8461

Phone

(907) 561-9220

Fax

(907) 561-9221

NPI assigned

Feb 2, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Chad Mangum

Title

Owner

Phone

(435) 514-5646

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Triton Supply

  • Durable Medical Equipment & Medical Supplies
  • Tempe, AZ
  • NPI 1770966863

  6608240536

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Triton Supply2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Triton Supply

  • Durable Medical Equipment & Medical Supplies
  • Tempe, AZ
  • NPI 1770966863
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1326744137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4682",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843234682",
            "telephone_number": "800-599-8553",
            "fax_number": "435-774-1919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3831 E BLUE LUPINE DR STE B2",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996548461",
            "telephone_number": "907-561-9220",
            "fax_number": "907-561-9221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3815 E Bogard Rd",
            "address_purpose": "LOCATION",
            "city": "Wasilla",
            "state": "AK",
            "postal_code": "996546070",
            "country_code": "US",
            "telephone_number": "907-561-9220",
            "fax_number": "907-561-9221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TRITON SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-514-5646"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph James Trask
• Jamie Tresner
• Trinion Quality Care Services, Inc
• Trinion Quality Care Services, Inc
• Shailey Tripp, LMT, CMT, REIKI II
• Jacob Trudeau, PA-C
• True North Recovery
• True North Recovery Inc
• True North Recovery Inc
• True North Recovery Inc

• Durable Medical Equipment & Medical Supplies in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Durable Medical Equipment & Medical Supplies in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.