Healthcare Provider Details

I. General information

NPI: 1407955370
Provider Name (Legal Business Name): TRINICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 GRAND AVE
PAONIA CO
81428
US

IV. Provider business mailing address

PO BOX 29
PAONIA CO
81428-0029
US

V. Phone/Fax

Practice location:
  • Phone: 970-527-4109
  • Fax: 970-527-4108
Mailing address:
  • Phone: 970-527-4109
  • Fax: 970-527-4108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number1020000001
License Number StateCO

VIII. Authorized Official

Name: RICHARD MCGAUGHEY
Title or Position: OWNER
Credential: RPH
Phone: 970-527-4109