Provider Demographics
NPI:1972889434
Name:HATCHETT, TRINA (RPH)
Entity Type:Individual
Prefix:
First Name:TRINA
Middle Name:
Last Name:HATCHETT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30102 SPARKLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2076
Mailing Address - Country:US
Mailing Address - Phone:248-231-7337
Mailing Address - Fax:
Practice Address - Street 1:24133 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48219-3014
Practice Address - Country:US
Practice Address - Phone:313-541-0794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302032832183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist