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General NPI Number Information
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NPI Number | 1356997985
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Entity Type | Organization
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Legal Business Name | TRINITY'S PHARMACY
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Dates
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Enumeration Date | 08/09/2019
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 2745 HIGHWAY 371 N
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City | MANTACHIE
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State | MS
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Zip | 38855
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Country | US
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Telephone | 662-282-5757
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Fax | 662-282-5760
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Provider Business Mailing Address
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Address Line | 2745 HWY 371 N
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City | MANTACHIE
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State | MS
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Zip | 38855-9114
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Country | US
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Telephone | 662-282-5757
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Fax | 662-282-5760
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Authorized Official
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Title or Position | OWNER/PHARMACIST IN CHARGE
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Name | TRINITY K NICHOLS
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Credential | PHARMD
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Telephone | 662-401-2805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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