Healthcare Provider Details

I. General information

NPI: 1497167647
Provider Name (Legal Business Name): TRIHEALTH Q LLC DBA QUEEN CITY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 08/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1775 LEXINGTON AVE SUITE 150
CINCINNATI OH
45212
US

IV. Provider business mailing address

1775 LEXINGTON AVE SUITE 150
CINCINNATI OH
45212
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-8000
  • Fax: 513-871-2824
Mailing address:
  • Phone: 513-246-8000
  • Fax: 513-871-2824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PAMELA COYLE-TOERNER
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 513-246-8001