TRINITY HEALTH & WELLNESS FAMILY PRACTICE PLLC (NPI# 1295246932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295246932 |
| Entity Type | Organization |
| Organization Name | TRINITY HEALTH & WELLNESS FAMILY PRACTICE PLLC |
| Practice Address |
45 Capri Blvd Ste F Lake Havasu City AZ 86403-5657 |
| Mailing Address |
3869 Chesapeake Pl Lake Havasu City AZ 86406-4343 |
| Practice Telephone | 9282341177 |
| Practice Fax Number | 9287336259 |
| Mailing Telephone | 6037315907 |
| Enumeration Date | 2017-10-21 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | CHRIS ANN DIPAOLA (FAMILY NURSE PRACTITIONER) |
| Authorized Official Telephone | 6037315907 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
AP9834 | AZ | Ambulatory Health Care Facilities |
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
AP9834 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1669836748 | 05 |
| Street Address |
45 CAPRI BLVD STE F |
| City | LAKE HAVASU CITY |
| State | AZ |
| Zip Code | 86403-5657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479039 | Liska's Apothecary Shop, Inc. | Assisted Living Facility | 1840 Mesquite Ave., Ste. E, Lake Havasu City, AZ 86403 | 2019-07-19 |
| 1275033227 | Ayad Costy | Pharmacist | 75 North Lake Havasu City, Lake Havasu City, AZ 86403 | 2018-02-16 |
| 1942727250 | Ideal Health Care, L.L.C. | Prosthetic/Orthotic Supplier | 1675 Mesquite Ave Ste A, Lake Havasu City, AZ 86403 | 2017-08-28 |
| 1063965036 | Cerner Health Connections, Inc | Clinic/Center | 89 Civic Center Blvd, Lake Havasu City, AZ 86403 | 2016-07-26 |
| 1447643358 | Lundin Dental PC | Durable Medical Equipment & Medical Supplies | 1741 Mesquite Avenue Ste B 100, Lake Havasu City, AZ 86403 | 2015-03-17 |
| 1912301425 | Arizona Havasu Bdm Pak LLC | Dentist | 1799 North Kiowa Blvd, Unit 109, Lake Havasu, AZ 86403 | 2014-10-13 |
| 1386047850 | Emily E Vona | Nurse Practitioner | 84 Acoma Blvd N Ste 104, Lake Havasu City, AZ 86403 | 2014-09-29 |
| 1750700589 | Thomas Wennergren | Pharmacist | 25 S Lake Havasu Ave, Lake Havasu City, AZ 86403 | 2014-04-09 |
| 1285997460 | Jamie L Lemire | Pharmacist | 1980 Mcculloch Blvd, Lake Havasu City, AZ 86403 | 2012-06-21 |
| 1053694448 | Goodwill of Northern Arizona | Exclusive Provider Organization | 1990 Mcculloch Blvd North, Lake Havasu City, AZ 86403 | 2011-09-22 |
| Find all providers in zip 86403 | ||||
| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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| 1548807514 | The Horizon Chiropractic Center | Clinic/Center | 4425 East Agave Road Suite 104, Phoenix, AZ 85044 | 2019-12-09 |
| 1528604923 | Maricopa County Special Health Care District | Clinic/Center | 8088 West Whitney Dr., Peoria, AZ 85345 | 2019-11-20 |
| 1114561107 | Vista Mobile Health, LLC | Clinic/Center | 10752 N 89th Pl # 104a-1, Scottsdale, AZ 85260-6730 | 2019-11-01 |
| 1477104362 | Modern Recovery, LLC | Clinic/Center | 4820 S Mill Ave Ste 203, Tempe, AZ 85282-7734 | 2019-09-23 |
| 1063068898 | Ambest Family Health Clinics, Pllc | Clinic/Center | 4841 S Mesa Villas Dr Apt 3, Fort Mohave, AZ 86426-6436 | 2019-08-16 |
| 1073178133 | Tammy Lynn Undiemi | Clinic/Center | 27575 N 172nd Ln, Surprise, AZ 85387-1126 | 2019-05-04 |
| 1871058891 | Dental and Braces Maryvale LLC | Clinic/Center | 6702 W Camelback Rd Ste 100, Glendale, AZ 85303-6324 | 2019-02-04 |
| 1154806446 | Cook Family Healthcare & Professional Services, PC | Clinic/Center | 9700 N. 91st. Street, Ste. A-115, Scottsdlae, AZ 85258 | 2018-10-02 |
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| City | LAKE HAVASU CITY |
| Zip Code | 86403 |
Please comment or provide details below to improve the information on TRINITY HEALTH & WELLNESS FAMILY PRACTICE PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.