Healthcare Provider Details

I. General information

NPI: 1790106854
Provider Name (Legal Business Name): TRIXICORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 MURFREESBORO PIKE SUITE 9
NASHVILLE TN
37217-3582
US

IV. Provider business mailing address

2510 MURFREESBORO PIKE SUITE 9
NASHVILLE TN
37217-3582
US

V. Phone/Fax

Practice location:
  • Phone: 615-948-1695
  • Fax: 615-953-2507
Mailing address:
  • Phone: 615-953-2402
  • Fax: 615-953-2507

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. CHIKE HENRY EZEOKE
Title or Position: OWNER
Credential: R.PH
Phone: 615-948-1695