| Trinity Medical Clinic, Llc | |
|
832 Mulberry Ave Selmer TN 38375-2334 | |
| (731) 434-0200 | |
| (731) 434-0203 |
| Full Name | Trinity Medical Clinic, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 832 Mulberry Ave, Selmer, Tennessee |
| Authorized Official Name and Position | Rhonda L Hunt (OWNER) |
| Authorized Official Contact | 7314340200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trinity Medical Clinic, Llc 832 Mulberry Ave Selmer TN 38375-2334 Ph: (731) 424-0200 | Trinity Medical Clinic, Llc 832 Mulberry Ave Selmer TN 38375-2334 Ph: (731) 434-0200 |
| NPI Number | 1013156629 |
|---|---|
| Provider Enumeration Date | 02/05/2009 |
| Last Update Date | 09/19/2019 |
| Medicare PECOS PAC ID | 5395802912 |
|---|---|
| Medicare Enrollment ID | O20090326000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013156629 | NPI | - | NPPES |
| 3341736 | Other | TN | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | APN0000007669 (Tennessee) | Primary |
| Provider Name | Rhonda L Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215050406 PECOS PAC ID: 6002994274 Enrollment ID: I20080429000417 |
| Provider Name | Mary J Fullwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306208954 PECOS PAC ID: 1254624554 Enrollment ID: I20191030000848 |
| Provider Name | Carie Allison Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477144632 PECOS PAC ID: 8820404007 Enrollment ID: I20210312001878 |
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