MEDICARE: TRINITY ORTHOTICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225000000X	Orthotic Fitter
2	332B00000X	Durable Medical Equipment & Medical Supplies	5265100001	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82-00654	OTHER	OH	EVERCARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000359414	OTHER	OH	ANTHEM BC/BS

General Provider Information

NPI Number	:	1902801913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY ORTHOTICS INC

Provider Business Mailing Address
First Line	:	230 NORTHLAND BLVD
Second Line	:	SUITE 231
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3600
Country	:	US
Telephone Number	:	513-771-2603
Fax Number	:

Provider Business Practice Location Address
First Line	:	230 NORTHLAND BLVD
Second Line	:	SUITE 231
City	:	CINCINNATI
State	:	OH
Zip	:	45246-3600
Country	:	US
Telephone Number	:	513-771-2603
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. DONNA PAULINE MAHAN
Credential	:
Telephone Number	:	513-771-2603

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	02/21/2008

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Directions to “TRINITY ORTHOTICS INC ” Practice Location

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