Healthcare Provider Details

I. General information

NPI: 1508124280
Provider Name (Legal Business Name): TRIHEALTH PHYSICIAN INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 08/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 HAUCK RD SUITE A
CINCINNATI OH
45241-4607
US

IV. Provider business mailing address

PO BOX 637706
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 513-872-0669
  • Fax: 513-872-0601
Mailing address:
  • Phone: 513-872-0669
  • Fax: 513-872-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DONNA S NIENABER
Title or Position: SENIOR VP CORPORATE COUNSEL
Credential:
Phone: 513-569-6062