Healthcare Provider Details

I. General information

NPI: 1124421557
Provider Name (Legal Business Name): TRIHEALTH PHYSCIAN INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2866 BOUDINOT AVE
CINCINNATI OH
45238-7400
US

IV. Provider business mailing address

4685 FOREST AVE SUITE C
CINCINNATI OH
45212-3397
US

V. Phone/Fax

Practice location:
  • Phone: 513-922-5285
  • Fax: 513-852-8525
Mailing address:
  • Phone: 513-853-4721
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DONNA NIENABER
Title or Position: SR VP CORP COUNSEL
Credential:
Phone: 513-569-6062