Healthcare Provider Details

I. General information

NPI: 1639580657
Provider Name (Legal Business Name): TRIHEALTH OS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 07/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7450 S MASON MONTGOMERY RD SUITE 208
MASON OH
45040-7802
US

IV. Provider business mailing address

PO BOX 637783
CINCINNATI OH
45263-7783
US

V. Phone/Fax

Practice location:
  • Phone: 513-791-6611
  • Fax: 513-221-4848
Mailing address:
  • Phone: 513-853-4749
  • Fax: 513-853-4740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA NIENABER
Title or Position: SENIOR VP CORP COUSEL
Credential:
Phone: 513-569-6062