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General NPI Number Information
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NPI Number | 1306732938
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Entity Type | Organization
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Legal Business Name | TRINITY SURGICAL LLC
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 277 COVINGTON DR
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City | HIRAM
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State | GA
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Zip | 30141-2257
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Country | US
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Telephone | 757-287-8914
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Fax |
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Provider Business Mailing Address
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Address Line | 277 COVINGTON DR
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City | HIRAM
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State | GA
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Zip | 30141-2257
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Country | US
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Telephone | 470-243-0174
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Fax | 844-550-4221
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE BULLOCK
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Credential | CSA, MSA
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Telephone | 470-243-0174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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