MEDICARE: PETER TRINH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	12898	NV

General Provider Information

NPI Number	:	1154607273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER TRINH

Provider Business Mailing Address
First Line	:	4180 S RAINBOW BLVD STE 808
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3135
Country	:	US
Telephone Number	:	702-998-9791
Fax Number	:	702-998-9881

Provider Business Practice Location Address
First Line	:	4180 S RAINBOW BLVD STE 808
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3135
Country	:	US
Telephone Number	:	702-998-9791
Fax Number	:	702-998-9881

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2011
Last Update Date	:	08/19/2014

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Directions to “ PETER TRINH ” Practice Location

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