Provider Demographics
NPI:1679122337
Name:TRENTON MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:TRENTON MEDICAL CENTER, INC.
Other - Org Name:PALMS PHARMACY OF LAKE CITY WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:H
Authorized Official - Last Name:REMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-463-4501
Mailing Address - Street 1:23343 NW COUNTY ROAD 236
Mailing Address - Street 2:
Mailing Address - City:HIGH SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32643-9669
Mailing Address - Country:US
Mailing Address - Phone:386-454-0690
Mailing Address - Fax:
Practice Address - Street 1:4784 W US HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-3101
Practice Address - Country:US
Practice Address - Phone:386-269-9261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy