Provider Demographics
NPI:1710541669
Name:TRINITY MEDICAL CENTER LLC
Entity Type:Organization
Organization Name:TRINITY MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRYHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-667-3708
Mailing Address - Street 1:2245 COUNTY ROAD 93
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:AL
Mailing Address - Zip Code:35610-4125
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 GOVERNORS DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5126
Practice Address - Country:US
Practice Address - Phone:256-667-3708
Practice Address - Fax:888-386-3128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-25
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty