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ICE20 - TRIAD SPORTS GROUP, LLC
NPI 1285964932
Durable Medical Equipment & Medical Supplies in Camarillo, CA

Active since December 31, 2009
4690 CALLE QUETZAL, CAMARILLO, CA 93012(805) 857-4172 Get Directions Write a Review

NPPES record last updated: October 7, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ice20 - Triad Sports Group, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ICE20 - TRIAD SPORTS GROUP, LLC (NPI 1285964932) is a healthcare organization registered as a durable medical equipment & medical supplies in Camarillo, California and active in the NPI registry since December 2009. The organization lists Brad L Smith, Division President, as its authorized official.

NPPES Registry Identity

NPI1285964932
Entity TypeOrganization
Primary Taxonomy332B00000X
Legal Business NameICE20 - TRIAD SPORTS GROUP, LLC
Location Address4690 CALLE QUETZALCamarillo, CA 93012-8558
Mailing Address4690 Calle QuetzalCamarillo, CA 93012-8558 · (805) 857-4172
Phone(805) 857-4172
Organization SubpartYesParent: Triad Sports Group, Llc
Authorized OfficialBrad L SmithDivision President · (805) 857-4172
Enumeration DateDecember 31, 2009
Last NPPES UpdateOctober 7, 2014
✔ NPI 1285964932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDurable Medical Equipment & Medical SuppliesSuppliers
Taxonomy Code332B00000X
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
4690 CALLE QUETZAL, Camarillo, CA 93012
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ice20 - Triad Sports Group, LLC's NPI number?

The NPI number for Ice20 - Triad Sports Group, LLC is 1285964932. It was assigned to this organization in the NPPES registry on December 31, 2009.

Where is Ice20 - Triad Sports Group, LLC located?

Ice20 - Triad Sports Group, LLC is located at 4690 Calle Quetzal, Camarillo, CA 93012. The listed phone number is (805) 857-4172.

What is Ice20 - Triad Sports Group, LLC's specialty?

The primary specialty registered for this NPI is Durable Medical Equipment & Medical Supplies with taxonomy code 332B00000X.

When was this NPI record last updated?

The NPPES record for Ice20 - Triad Sports Group, LLC was last updated on October 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.