Healthcare Provider Details

I. General information

NPI: 1265513048
Provider Name (Legal Business Name): TRIHEALTH PHYSICIAN INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10496 MONTGOMERY RD SUITE 203
CINCINNATI OH
45242-5223
US

IV. Provider business mailing address

PO BOX 631914
CINCINNATI OH
45263-1914
US

V. Phone/Fax

Practice location:
  • Phone: 513-745-2358
  • Fax: 513-745-1405
Mailing address:
  • Phone: 513-569-5027
  • Fax: 513-569-5199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. DONNA S NIENABER
Title or Position: CORPORATE SECRETARY-BOARD MEMBER
Credential:
Phone: 513-569-6386