MEDICARE: TRINITY HEALTHCARE SERVICES, INC

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
1	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1356870349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY HEALTHCARE SERVICES, INC

Provider Business Mailing Address
First Line	:	5295 RIVERCHASE DR APT 805
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-7511
Country	:	US
Telephone Number	:	706-330-8498
Fax Number	:

Provider Business Practice Location Address
First Line	:	5295 RIVERCHASE DR APT 805
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-7511
Country	:	US
Telephone Number	:	706-330-8498
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	TIFFANY SANQUITA FIELDS
Credential	:	RN
Telephone Number	:	706-330-8498

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	07/21/2022

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