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NPI Code Detail

MEDICARE: TRINITY MEDICAL CLINIC, LLC

MEDICARE: TRINITY MEDICAL CLINIC, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR1300XRural Health Clinic/Center
2363LF0000XFamily Nurse PractitionerAPN0000007669TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13341736OTHERTNMEDICARE PTAN

General Provider Information

NPI Number : 1013156629
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRINITY MEDICAL CLINIC, LLC
Provider Business Mailing Address
First Line : 832 MULBERRY AVE
Second Line :
City : SELMER
State : TN
Zip : 38375-2334
Country : US
Telephone Number : 731-424-0200
Fax Number : 731-434-0203
Provider Business Practice Location Address
First Line : 832 MULBERRY AVE
Second Line :
City : SELMER
State : TN
Zip : 38375-2334
Country : US
Telephone Number : 731-434-0200
Fax Number : 731-434-0203
Authorized Official
Title or Position : OWNER
Name : MRS. RHONDA L HUNT
Credential : FNP
Telephone Number : 731-434-0200
Provider Enumeration Date : 02/05/2009
Last Update Date : 06/19/2024

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Directions to “TRINITY MEDICAL CLINIC, LLC ” Practice Location

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