Provider Demographics
NPI:1144619362
Name:TRINITY PHARMACY LLC
Entity Type:Organization
Organization Name:TRINITY PHARMACY LLC
Other - Org Name:TRINITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-573-2687
Mailing Address - Street 1:2797 S MARYLAND PKWY STE 28
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-1576
Mailing Address - Country:US
Mailing Address - Phone:973-573-2687
Mailing Address - Fax:702-776-7195
Practice Address - Street 1:2797 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-5032
Practice Address - Country:US
Practice Address - Phone:702-776-8210
Practice Address - Fax:702-776-7195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPH032873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149597OtherPK
NV7363840001Medicare NSC