Provider Demographics
NPI:1356997985
Name:TRINITY'S PHARMACY
Entity type:Organization
Organization Name:TRINITY'S PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:TRINITY
Authorized Official - Middle Name:K
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:662-401-2805
Mailing Address - Street 1:2745 HWY 371 N
Mailing Address - Street 2:
Mailing Address - City:MANTACHIE
Mailing Address - State:MS
Mailing Address - Zip Code:38855-9114
Mailing Address - Country:US
Mailing Address - Phone:662-282-5757
Mailing Address - Fax:662-282-5760
Practice Address - Street 1:2745 HIGHWAY 371 N
Practice Address - Street 2:
Practice Address - City:MANTACHIE
Practice Address - State:MS
Practice Address - Zip Code:38855
Practice Address - Country:US
Practice Address - Phone:662-282-5757
Practice Address - Fax:662-282-5760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-09
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy