Trinity Valley Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0001885 Issued in OR

Legal business name

TRINITY VALLEY PHARMACY LLC

Practice address

2001 NE Foothill Blvd
BLDG F3
Grants Pass, OR 97526-3947

Phone

(541) 474-9437

Fax

(541) 955-4575

NPI assigned

Mar 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clarissa Elaine Free, CPHT

Title

Owner

Phone

(541) 474-9437

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• TRINITY VALLEY PHARMACY LLC RETAIL Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nancy Elaine Hinke, RPH

  • Pharmacist
  • Grants Pass, OR
  • NPI 1013144765
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1013034735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 NE FOOTHILL BLVD",
            "address_2": "BLDG F3",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975263947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 NE FOOTHILL BLVD",
            "address_2": "BLDG F3",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975263947",
            "telephone_number": "541-474-9437",
            "fax_number": "541-955-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY VALLEY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A",
        "authorized_official_last_name": "FREE",
        "authorized_official_first_name": "CLARISSA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-474-9437",
        "authorized_official_credential": "CPHT"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "OR",
            "license": "0001885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2079136",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226575",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRINITY VALLEY PHARMACY LLC RETAIL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TRINITY VALLEY PHARMACY LLC RETAIL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Trinity Valley Pharmacy, LLC
• Amy Tripp
• John Matthew Tripp, EPDH, LD
• Amaka Troxell, MA
• Shirley F Tschetter

• Community/Retail Pharmacy in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Community/Retail Pharmacy in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.