Provider Demographics
NPI:1588273684
Name:TRINITY PHARMACY LLC
Entity type:Organization
Organization Name:TRINITY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:SY
Authorized Official - Last Name:BHATIA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:201-360-0600
Mailing Address - Street 1:55 EBERHARDT RD
Mailing Address - Street 2:
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936-3051
Mailing Address - Country:US
Mailing Address - Phone:702-776-8210
Mailing Address - Fax:
Practice Address - Street 1:2797 S MARYLAND PKWY STE 28
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-1576
Practice Address - Country:US
Practice Address - Phone:702-776-8210
Practice Address - Fax:702-776-7195
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRINITY PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1144619362Medicaid