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General NPI Number Information
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NPI Number | 1639486491
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Entity Type | Organization
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Legal Business Name | TRINITY PHARMACY ENTERPRISE, LLC
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Dates
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Enumeration Date | 08/31/2010
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 3565 MARTIN LUTHER KING JR DR SW STE 2
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City | ATLANTA
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State | GA
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Zip | 30331-4016
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Country | US
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Telephone | 678-705-5690
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Fax | 678-705-5625
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Provider Business Mailing Address
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Address Line | 2505 GREENES LN
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-3719
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Country | US
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Telephone | 678-949-0994
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | MRS. CLEMENTINE NANJE
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Credential |
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Telephone | 678-949-0994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHRE009673
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License Number State | GA
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