Provider Demographics
NPI:1780865139
Name:TRISKEL, INC.
Entity Type:Organization
Organization Name:TRISKEL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-864-8898
Mailing Address - Street 1:71 BAKER BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313
Mailing Address - Country:US
Mailing Address - Phone:330-836-2254
Mailing Address - Fax:330-836-2417
Practice Address - Street 1:71 BAKER BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3639
Practice Address - Country:US
Practice Address - Phone:330-836-2254
Practice Address - Fax:330-836-2417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2156876Medicaid
OH2156876Medicaid