Provider Demographics
NPI:1598348211
Name:TRINITY HOLISTIC PRIMARY CARE
Entity Type:Organization
Organization Name:TRINITY HOLISTIC PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:901-653-4136
Mailing Address - Street 1:335 LILLIAN DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-4431
Mailing Address - Country:US
Mailing Address - Phone:901-653-4136
Mailing Address - Fax:901-509-3991
Practice Address - Street 1:335 LILLIAN DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38109-4431
Practice Address - Country:US
Practice Address - Phone:901-653-4136
Practice Address - Fax:901-509-3991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care