Provider Demographics
NPI:1871885038
Name:TRIHEALTH W. LLC,
Entity type:Organization
Organization Name:TRIHEALTH W. LLC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP CORPORATE COUNCIL
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NIENABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6062
Mailing Address - Street 1:PO BOX 637407
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-487-4693
Mailing Address - Fax:513-487-4590
Practice Address - Street 1:3440 BURNET AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2843
Practice Address - Country:US
Practice Address - Phone:513-487-4593
Practice Address - Fax:513-487-4590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-06
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3156141Medicaid
OHH015650Medicare PIN