Provider Demographics
NPI:1851306310
Name:TRIHEALTH Q, LLC
Entity Type:Organization
Organization Name:TRIHEALTH Q, LLC
Other - Org Name:QUEEN CITY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE-TOERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-871-3444
Mailing Address - Street 1:3621 ROSSGATE CT
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-9558
Mailing Address - Country:US
Mailing Address - Phone:513-738-0500
Mailing Address - Fax:513-738-0502
Practice Address - Street 1:3621 ROSSGATE CT
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-9558
Practice Address - Country:US
Practice Address - Phone:513-738-0500
Practice Address - Fax:513-738-0502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIHEALTH PHYSICIANS ENTERPRISE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-30
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2626046Medicaid