Provider Demographics
NPI:1467655977
Name:TRIHEALTH
Entity Type:Organization
Organization Name:TRIHEALTH
Other - Org Name:BETHESDA FAMILY MEDICINE RESIDENCY
Other - Org Type:Other Name
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-631-0763
Mailing Address - Street 1:4411 MONTGOMERY RD
Mailing Address - Street 2:#206
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3187
Mailing Address - Country:US
Mailing Address - Phone:513-631-0763
Mailing Address - Fax:
Practice Address - Street 1:4411 MONTGOMERY RD
Practice Address - Street 2:#206
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45212-3187
Practice Address - Country:US
Practice Address - Phone:513-631-0763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty