Basic Information
Provider Information
NPI: 1154743094
EntityType: 2
ReplacementNPI:  
OrganizationName: TRIHEALTH OS, LLC
LastName:  
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Mailing Information
Address1: PO BOX 637783
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452637783
CountryCode: US
TelephoneNumber: 5138534731
FaxNumber: 5135695199
Practice Location
Address1: 379 DIXMYTH AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452202475
CountryCode: US
TelephoneNumber: 5132467000
FaxNumber: 5132462914
Other Information
ProviderEnumerationDate: 01/13/2014
LastUpdateDate: 01/13/2014
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: NEINABER
AuthorizedOfficialFirstName: DONNA
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AuthorizedOfficialTitleorPosition: SR. VP CORP COUNSEL
AuthorizedOfficialTelephone: 5135696062
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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