Provider Demographics
NPI:1639605876
Name:TRIHEALTH G LLC
Entity Type:Organization
Organization Name:TRIHEALTH G LLC
Other - Org Name:TRIHEALTH HOSPITALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-5126
Mailing Address - Street 1:4685 FOREST AVE
Mailing Address - Street 2:STE. C
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3397
Mailing Address - Country:US
Mailing Address - Phone:513-853-4684
Mailing Address - Fax:513-852-8525
Practice Address - Street 1:375 DIXMYTH AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2475
Practice Address - Country:US
Practice Address - Phone:513-862-3452
Practice Address - Fax:513-862-3421
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIHEALTH G LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-09
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid
OH9353571Medicare PIN