Healthcare Provider Details

I. General information

NPI: 1023062676
Provider Name (Legal Business Name): TRIHEALTH PHYSICIAN PRACTICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 OHIO PIKE SUITE 300
CINCINNATI OH
45255-3721
US

IV. Provider business mailing address

PO BOX 637676
CINCINNATI OH
45263-7676
US

V. Phone/Fax

Practice location:
  • Phone: 513-528-5600
  • Fax:
Mailing address:
  • Phone: 513-528-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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