Healthcare Provider Details

I. General information

NPI: 1003728809
Provider Name (Legal Business Name): TRIVANTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 N WILSON RD APT 53
COLUMBUS OH
43204-1228
US

IV. Provider business mailing address

173 N WILSON RD APT 53
COLUMBUS OH
43204-1228
US

V. Phone/Fax

Practice location:
  • Phone: 614-301-2700
  • Fax:
Mailing address:
  • Phone: 614-301-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: YUSUF ALI ABDULLE
Title or Position: OWNER
Credential:
Phone: 614-301-2700