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General NPI Number Information
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NPI Number | 1487080214
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Entity Type | Organization
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Legal Business Name | TRINOV PLLC
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 336 W. FIRST STREET SUITTE 113
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City | FLINT
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State | MI
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Zip | 48502
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Country | US
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Telephone | 248-254-6407
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Fax |
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Provider Business Mailing Address
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Address Line | 23628 LONDON CT
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3314
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Country | US
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Telephone | 313-495-3534
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. COSMOS NELO GEORGE II
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Credential | PHARMD
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Telephone | 248-254-6407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5302032227
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License Number State | MI
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