Healthcare Provider Details

I. General information

NPI: 1780273680
Provider Name (Legal Business Name): PAITON TROVINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB NM
88330-8273
US

IV. Provider business mailing address

280 DAVID L GOLDFEIN ST BLDG 23
HOLLOMAN AFB NM
88330-8273
US

V. Phone/Fax

Practice location:
  • Phone: 575-572-0314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00010027
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: