Provider Demographics
NPI:1598710881
Name:BETHESDA HOSPITAL, INC
Entity Type:Organization
Organization Name:BETHESDA HOSPITAL, INC
Other - Org Name:TRIHEALTH NURSE MIDWIVES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIENABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-862-1400
Mailing Address - Street 1:PO BOX 633370
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-3370
Mailing Address - Country:US
Mailing Address - Phone:513-569-5027
Mailing Address - Fax:513-569-5199
Practice Address - Street 1:3440 BURNET AVE
Practice Address - Street 2:STE. 120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2833
Practice Address - Country:US
Practice Address - Phone:513-751-5900
Practice Address - Fax:513-487-4590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78903101Medicaid
IN200409040AMedicaid
OH2441950Medicaid
OH2518001Medicaid
IN200409040CMedicaid
IN200409040BMedicaid
OH2358498Medicaid
KY78903101Medicaid