Provider Demographics
NPI:1255689741
Name:TRIHEALTH SENIORLINK
Entity Type:Organization
Organization Name:TRIHEALTH SENIORLINK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MYERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-458-8845
Mailing Address - Street 1:4750 WESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2244
Mailing Address - Country:US
Mailing Address - Phone:513-531-5110
Mailing Address - Fax:513-531-1327
Practice Address - Street 1:4750 WESLEY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-2244
Practice Address - Country:US
Practice Address - Phone:513-531-5110
Practice Address - Fax:513-531-1327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH160163WA2000X302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization