Healthcare Provider Details
I. General information
NPI: 1013232909
Provider Name (Legal Business Name): TRIHEALTH ONCOLOGY INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/02/2010
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5520 CHEVIOT RD
CINCINNATI OH
45247-7069
US
IV. Provider business mailing address
5520 CHEVIOT RD
CINCINNATI OH
45247-7069
US
V. Phone/Fax
- Phone: 513-451-4033
- Fax: 513-451-4118
- Phone: 513-451-4033
- Fax: 513-451-4118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 35-07-3663-B |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 35-87785 |
| License Number State | OH |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 35-042128 |
| License Number State | OH |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 35-075102 |
| License Number State | OH |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | 35-081652 |
| License Number State | OH |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 35-04-4152 |
| License Number State | OH |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 35-089253 |
| License Number State | OH |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0001X |
| Taxonomy | Radiation Oncology Physician |
| License Number | 35-058268 |
| License Number State | OH |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | 50-00-2071 |
| License Number State | OH |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 364SX0200X |
| Taxonomy | Oncology Clinical Nurse Specialist |
| License Number | NP-09365 |
| License Number State | OH |
VIII. Authorized Official
Name:
ELAINE
M
BEDINGHAUS
Title or Position: BILLING MANAGER
Credential:
Phone: 513-451-4033