Provider Demographics
NPI:1700153178
Name:TRIHEALTH G LLC
Entity Type:Organization
Organization Name:TRIHEALTH G LLC
Other - Org Name:GROUP HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP & CORPORATE COUNSEL
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:513-569-6062
Mailing Address - Street 1:4685 FOREST AVE STE C
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-3359
Mailing Address - Country:US
Mailing Address - Phone:513-246-7796
Mailing Address - Fax:513-852-8525
Practice Address - Street 1:3219 CLIFTON AVE
Practice Address - Street 2:STE 225
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-3027
Practice Address - Country:US
Practice Address - Phone:513-246-7800
Practice Address - Fax:513-862-2057
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIHEALTH G LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-29
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2565399Medicaid
OH2565399Medicaid