| Golden Trinity Healthcare Llc | |
|
40616 W Art Pl Maricopa AZ 85138-5221 | |
| (480) 567-2526 | |
| (480) 750-2444 |
| Full Name | Golden Trinity Healthcare Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 40616 W Art Pl, Maricopa, Arizona |
| Authorized Official Name and Position | Tandra Garvin (PROVIDER) |
| Authorized Official Contact | 4805672526 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Trinity Healthcare Llc 20987 N John Wayne Pkwy # B104-215 Maricopa AZ 85139-2926 Ph: (480) 567-2526 | Golden Trinity Healthcare Llc 40616 W Art Pl Maricopa AZ 85138-5221 Ph: (480) 567-2526 |
| NPI Number | 1669942645 |
|---|---|
| Provider Enumeration Date | 12/03/2018 |
| Last Update Date | 03/15/2019 |
| Medicare PECOS PAC ID | 8022446061 |
|---|---|
| Medicare Enrollment ID | O20200325001129 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669942645 | NPI | - | NPPES |
| 1881140259 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Tandra Arlene Garvin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881140259 PECOS PAC ID: 7214217181 Enrollment ID: I20161212000602 |
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