Healthcare Provider Details

I. General information

NPI: 1184667339
Provider Name (Legal Business Name): TRIHEALTH PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 CARVER WOODS DR SUITE 100
CINCINNATI OH
45242-5536
US

IV. Provider business mailing address

PO BOX 637676
CINCINNATI OH
45263-5156
US

V. Phone/Fax

Practice location:
  • Phone: 513-792-4700
  • Fax: 513-792-4703
Mailing address:
  • Phone: 513-792-4700
  • Fax: 513-569-6320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DONNA S NIENABER
Title or Position: SOLE MEMBER
Credential:
Phone: 513-862-1400