Basic Information
| Provider Information | |||||||||
| NPI: | 1285290593 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TRILLIUM HEALTH, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 259 MONROE AVENUE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5854652015 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 SCIENCE PKWY | ||||||||
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| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146204251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5855457200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2019 | ||||||||
| LastUpdateDate: | 05/13/2019 | ||||||||
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| AuthorizedOfficialLastName: | SAHRLE | ||||||||
| AuthorizedOfficialFirstName: | JENNIFER | ||||||||
| AuthorizedOfficialMiddleName: | JO | ||||||||
| AuthorizedOfficialTitleorPosition: | SR. DIRECTOR, OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 5854652015 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MSED, PMP, SHRM-SCP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | N | Ambulatory Health Care Facilities | Clinic/Center | 261QP2300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.