Provider Demographics
NPI:1881284891
Name:TRINITY COMPREHENSIVE HEALTHCARE CENTER
Entity type:Organization
Organization Name:TRINITY COMPREHENSIVE HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL COOWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:901-949-9916
Mailing Address - Street 1:PO BOX 750103
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38175-0103
Mailing Address - Country:US
Mailing Address - Phone:901-676-6218
Mailing Address - Fax:901-425-9639
Practice Address - Street 1:2838 HICKORY HILL RD STE 29
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-2161
Practice Address - Country:US
Practice Address - Phone:901-676-6218
Practice Address - Fax:901-425-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-23
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center