Provider Demographics
NPI:1811881105
Name:TRINITY GULF COAST LLC
Entity type:Organization
Organization Name:TRINITY GULF COAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHUNDREKIA
Authorized Official - Middle Name:TIERRA
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-406-5527
Mailing Address - Street 1:100 CARONDOLET CT S
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-5710
Mailing Address - Country:US
Mailing Address - Phone:251-406-5527
Mailing Address - Fax:
Practice Address - Street 1:100 CARONDOLET CT S
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-5710
Practice Address - Country:US
Practice Address - Phone:251-406-5527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service