Provider Demographics
NPI:1689364952
Name:TRINITY RX INC
Entity Type:Organization
Organization Name:TRINITY RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KINDLELYN
Authorized Official - Middle Name:SHAVAWN
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:480-364-9273
Mailing Address - Street 1:255 ASSAY ST APT 315
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-3522
Mailing Address - Country:US
Mailing Address - Phone:480-364-9273
Mailing Address - Fax:
Practice Address - Street 1:858 S ROBB ST
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:TX
Practice Address - Zip Code:75862
Practice Address - Country:US
Practice Address - Phone:936-594-4834
Practice Address - Fax:936-594-4837
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY RX INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy