Trinity Valley Pharmacy, LLC

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

License

001859 Issued in OR

Legal business name

TRINITY VALLEY PHARMACY, LLC

Practice address

2001 NE Foothill Blvd Ste F3
Grants Pass, OR 97526-7901

Phone

(541) 474-9437

Fax

(541) 955-4575

NPI assigned

Aug 10, 2006

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 Doing business as

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611619200000",
    "number": "1639180201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 NE FOOTHILL BLVD STE F3",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975267901",
            "telephone_number": "541-474-9437",
            "fax_number": "541-955-4575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 NE FOOTHILL BLVD STE F3",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975267901",
            "telephone_number": "541-474-9437",
            "fax_number": "541-955-4575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY VALLEY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "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": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "OR",
            "license": "001859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "226575",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2079118",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TRINITY VALLEY PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TRINITY VALLEY PHARMACY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amy Tripp
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• Amaka Troxell, MA
• Shirley F Tschetter
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• Long Term Care Pharmacy in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Long Term Care 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.