Healthcare Provider Details

I. General information

NPI: 1528605177
Provider Name (Legal Business Name): TRIHEALTH U LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 01/06/2020
Certification Date: 01/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 MONTGOMERY RD
CINCINNATI OH
45212-2607
US

IV. Provider business mailing address

4685 FOREST AVE
CINCINNATI OH
45212-3397
US

V. Phone/Fax

Practice location:
  • Phone: 135-853-9700
  • Fax:
Mailing address:
  • Phone: 513-853-4722
  • Fax: 513-852-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL CROFTON
Title or Position: VP FINANCE
Credential:
Phone: 513-569-6577