Healthcare Provider Details

I. General information

NPI: 1174654578
Provider Name (Legal Business Name): TRIHEALTH G., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ARROW SPRINGS BLVD STE 2600
LEBANON OH
45036-9863
US

IV. Provider business mailing address

4600 WESLEY AVE STE N
CINCINNATI OH
45212-2298
US

V. Phone/Fax

Practice location:
  • Phone: 513-872-4222
  • Fax:
Mailing address:
  • Phone: 513-841-5519
  • Fax: 513-841-1580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MELODIE BLACKLIDGE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 513-841-5535