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Contact Information

TRIDENT MEDICAL GROUP
888 OAKDALE RD NE
ATLANTA, GA30307-1210
 Phone: 678-997-9895
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Managed Care Organization Pharmacy

3336M0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for TRIDENT MEDICAL GROUP

NPI Number 1124854922
LBN Legal business name TRIDENT MEDICAL GROUP
Authorized official KATHRYN DUPHILY - (OPERATIONS MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 09/10/2024
Last updated 09/10/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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