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General NPI Number Information
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NPI Number | 1013924133
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Entity Type | Organization
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Legal Business Name | TRINITY DEVELOPMENT, LLC
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 201 E WATTS ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-1812
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Country | US
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Telephone | 334-393-5474
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Fax | 334-393-7433
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Provider Business Mailing Address
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Address Line | 201 E WATTS ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-1812
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Country | US
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Telephone | 334-393-5474
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Fax | 334-393-7433
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | MS. ASHLEY A WALDEN
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Credential |
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Telephone | 334-393-5474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | U1601
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License Number State | AL
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