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General NPI Number Information
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NPI Number | 1336686336
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Entity Type | Organization
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Legal Business Name | TRINITY HEALTHCARE
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Dates
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Enumeration Date | 01/27/2017
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 154 S LEROY ST
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City | METTER
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State | GA
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Zip | 30439-4631
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Country | US
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Telephone | 912-713-1007
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Fax | 912-450-0998
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Provider Business Mailing Address
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Address Line | 154 S LEROY ST
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City | METTER
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State | GA
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Zip | 30439-4631
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Country | US
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Telephone | 912-685-2246
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Fax | 912-685-2248
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Authorized Official
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Title or Position | PARTNER
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Name | JACQUELINE BROWN
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Credential | FNP
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Telephone | 912-713-1007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | RN194174
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License Number State | GA
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