Healthcare Provider Details

I. General information

NPI: 1811657588
Provider Name (Legal Business Name): HOLY TRINITY PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2021
Last Update Date: 12/22/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 STATE ROAD 54, STE STE 102
NEW PORT RICHEY FL
34655
US

IV. Provider business mailing address

10900 STATE ROAD 54, STE STE 102
NEW PORT RICHEY FL
34655
US

V. Phone/Fax

Practice location:
  • Phone: 727-312-4384
  • Fax: 727-312-4605
Mailing address:
  • Phone: 727-312-4384
  • Fax: 727-312-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: NANCY AWAD
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 551-221-5670