Provider Demographics
NPI:1184915068
Name:TRIHEALTH W. LLC
Entity type:Organization
Organization Name:TRIHEALTH W. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN COMPLIANCE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:AYLWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-569-6302
Mailing Address - Street 1:PO BOX 636406
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-853-4749
Mailing Address - Fax:513-853-4740
Practice Address - Street 1:7759 UNIVERSITY DR
Practice Address - Street 2:SUITE D
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6578
Practice Address - Country:US
Practice Address - Phone:513-569-6422
Practice Address - Fax:513-569-5199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-26
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100189620Medicaid
KY7100253770Medicaid
KY7100259480Medicaid
KY7100189900Medicaid