Organization
TRINITY DEVELOPMENT, LLC
Active
Other names
SOUTH ALABAMA OUTPATIENT SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ASHLEY A WALDEN (BUSINESS OFFICE MANAGER)
(334) 393-5474
Entity
Organization
Contact information
Practice address
201 E WATTS ST, ENTERPRISE, AL 36330-1812
(334) 393-5474
(334) 393-7433
Mailing address
201 E WATTS ST, ENTERPRISE, AL 36330-1812
(334) 393-5474
(334) 393-7433
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
U1601
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012237
BCBS AL PROVIDER NO
AL
01
—
7523305
AETNA PROVIDER NO
AL
05
—
ASC0064C
—
AL
Enumeration date
08/02/2006
Last updated
04/20/2008
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