Healthcare Provider Details

I. General information

NPI: 1689928889
Provider Name (Legal Business Name): TRIHEALTH PHYSICIAN PRACTICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2012
Last Update Date: 03/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6139 GLENWAY AVE
CINCINNATI OH
45211-6312
US

IV. Provider business mailing address

619 OAK ST
CINCINNATI OH
45206-1613
US

V. Phone/Fax

Practice location:
  • Phone: 513-569-6380
  • Fax: 513-569-6320
Mailing address:
  • Phone: 513-569-6380
  • 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: SENIOR VICE PRESIDENT, CORP COUNSEL
Credential:
Phone: 513-569-6062