MEDICARE: TRINITY SERVICES, 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
1	152W00000X	Optometrist

General Provider Information

NPI Number	:	1922181387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY SERVICES, LLC

Provider Business Mailing Address
First Line	:	5160 W TOTHILL CIR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-2067
Country	:	US
Telephone Number	:	586-822-4475
Fax Number	:	801-894-4539

Provider Business Practice Location Address
First Line	:	5160 W TOTHILL CIR
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-2067
Country	:	US
Telephone Number	:	586-822-4475
Fax Number	:	801-894-4539

Authorized Official
Title or Position	:	MEMBER CEO
Name	:	MR. MICHAEL SIMPSON
Credential	:
Telephone Number	:	586-822-4475

Provider Enumeration Date	:	10/21/2006
Last Update Date	:	08/22/2020

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