MEDICARE: DR. TRINITY WILLIAMS PHARM.D

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	PS56982	FL

General Provider Information

NPI Number	:	1932626009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRINITY WILLIAMS PHARM.D

Provider Business Mailing Address
First Line	:	12496 WINDY WILLOWS DR N
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32225-5947
Country	:	US
Telephone Number	:	850-209-3411
Fax Number	:

Provider Business Practice Location Address
First Line	:	2485 CABBAGE HAMMOCK RD
Second Line	:
City	:	SAINT AUGUSTINE
State	:	FL
Zip	:	32092-0557
Country	:	US
Telephone Number	:	850-209-3411
Fax Number	:

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

Provider Enumeration Date	:	08/29/2017
Last Update Date	:	05/29/2024

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