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Contact Information

TRINITY HEALTH PHARMACY SERVICES, LLC
12279 BLUFFTON ROAD
FORT WAYNE, IN46809
 Phone: 407-697-4277
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialty Pharmacy

3336S0011X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Mail Order Pharmacy

3336M0002X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for TRINITY HEALTH PHARMACY SERVICES, LLC

NPI # 1669016895
LBN Legal business name TRINITY HEALTH PHARMACY SERVICES, LLC
Authorized official DAMON REDDING - (VP AND CHIEF PHARMACY OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/31/2019
Last updated 04/25/2022 - About 4 years ago
Identifiers
CT Medicaid 008107334
ID Medicaid 202190019
IN Medicaid 300033160
MI Medicaid VS0172399
OH Medicaid 0391994
PA Medicaid 103759236
AK Other 193819 PHARMACY LICENSE
AZ Other Y008405 PHARMACY LICENSE
CO Other OSP.0007488 PHARMACY LICENSE
CT Other PCN.0003825 PHARMACY LICENSE
DE Other A9-0012676 PHARMACY LICENSE
FL Other PH33336 PHARMACY LICENSE
GA Other PHNR001945 PHARMACY LICENSE
HI Other PMP-1895 PHARMACY LICENSE
IA Other NR5450 PHARMACY LICENSE
ID Other 58582MS PHARMACY LICENSE
IL Other 054.021498 PHARMACY LICENSE
IN Other 60006758A PHARMACY LICENSE
KY Other IN2605 PHARMACY LICENSE
MD Other PO8489 PHARMACY LICENSE
ME Other MO40003141 PHARMACY LICENSE
MI Other 5301012447 PHARMACY LICENSE
MN Other 266265 PHARMACY LICENSE
MO Other 2021001793 PHARMACY LICENSE
MT Other PHA-MOP-LIC-84404 PHARMACY LICENSE
NC Other 14929 PHARMACY LICENSE
ND Other PHAR1918 PHARMACY LICENSE
NH Other NR2270 PHARMACY LICENSE
NJ Other 28RO00224700 PHARMACY LICENSE
NM Other PH0005403 PHARMACY LICENSE
NY Other 038275 PHARMACY LICENSE
OH Other 0240000154 PHARMACY LICENSE
OR Other RP-0003705 PHARMACY LICENSE
PA Other NP001573 PHARMACY LICENSE
SD Other 400-2266 PHARMACY LICENSE
UT Other 12766690-1708 PHARMACY LICENSE
VA Other 0214002479 PHARMACY LICENSE
VT Other 036.0134601 PHARMACY LICENSE
WI Other 2521-43 PHARMACY LICENSE
WV Other MO0561538 PHARMACY LICENSE
WY Other NR-51935 PHARMACY LICENSE
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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