Healthcare Provider Details

I. General information

NPI: 1003108267
Provider Name (Legal Business Name): TRIHEALTH W. LLC,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10495 MONTGOMERY RD SUITE 16
CINCINNATI OH
45242-4468
US

IV. Provider business mailing address

PO BOX 636358
CINCINNATI OH
45263-6358
US

V. Phone/Fax

Practice location:
  • Phone: 513-985-9017
  • Fax: 513-985-9036
Mailing address:
  • Phone: 513-985-9017
  • Fax: 513-985-9036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

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