Provider Demographics
NPI:1518373570
Name:TRIHEALTH PHYSICIAN PRACTICES LLC
Entity Type:Organization
Organization Name:TRIHEALTH PHYSICIAN PRACTICES LLC
Other - Org Name:TRIHEALTH PHYSICIAN PARTNERS GERIATRIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. VP CORPORATE COUNSEL
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 637676
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7676
Mailing Address - Country:US
Mailing Address - Phone:513-853-4684
Mailing Address - Fax:513-853-4743
Practice Address - Street 1:4750 WESLEY AVE
Practice Address - Street 2:SUITE J
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?:Yes
Parent Organization LBN:TRIHEALTH PHYSICIAN PRACTICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty