Provider Demographics
NPI:1093892028
Name:TRUSTED HEALTH CARE, INC.
Entity Type:Organization
Organization Name:TRUSTED HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JILIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-436-3833
Mailing Address - Street 1:341 SENTINEL OAK DR
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4074
Mailing Address - Country:US
Mailing Address - Phone:937-436-3833
Mailing Address - Fax:937-291-4562
Practice Address - Street 1:325 REGENCY RIDGE DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-4252
Practice Address - Country:US
Practice Address - Phone:937-436-3833
Practice Address - Fax:937-291-4562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-074883207R00000X
291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000235555OtherANTHEM
OH2379420Medicaid
OH2379420Medicaid