Provider Demographics
NPI:1982853040
Name:INGRAM, TRINA BRZEZINSKI (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:TRINA
Middle Name:BRZEZINSKI
Last Name:INGRAM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HUGHES RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1187
Mailing Address - Country:US
Mailing Address - Phone:256-461-8530
Mailing Address - Fax:256-464-5528
Practice Address - Street 1:300 HUGHES RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1187
Practice Address - Country:US
Practice Address - Phone:256-461-8530
Practice Address - Fax:256-464-5528
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-14
Last Update Date:2008-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist