Healthcare Provider Details

I. General information

NPI: 1336054717
Provider Name (Legal Business Name): TRINITY LONGEVITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1746 W 1770 S
WEST HAVEN UT
84401-3833
US

IV. Provider business mailing address

1746 W 1770 S
WEST HAVEN UT
84401-3833
US

V. Phone/Fax

Practice location:
  • Phone: 385-580-9127
  • Fax: 385-580-9127
Mailing address:
  • Phone: 385-580-9127
  • Fax: 385-580-9127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY GENE PATTERSON
Title or Position: MANAGING MEMBER
Credential:
Phone: 385-580-9127