Healthcare Provider Details

I. General information

NPI: 1871833145
Provider Name (Legal Business Name): TRIHEALTH Q, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 HAMILTON MASON RD SUITE 200
HAMILTON OH
45011-5544
US

IV. Provider business mailing address

3035 HAMILTON MASON RD SUITE 200
HAMILTON OH
45011-5544
US

V. Phone/Fax

Practice location:
  • Phone: 513-738-0500
  • Fax:
Mailing address:
  • Phone: 513-738-0500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number000000
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number00000000
License Number StateOH

VIII. Authorized Official

Name: PAMELA COYLE-TOERNER
Title or Position: CEO
Credential: MHA
Phone: 513-246-8005