Provider Demographics
NPI:1336458165
Name:TRIHEALTH Q LLC
Entity type:Organization
Organization Name:TRIHEALTH Q LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
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:513-246-8001
Mailing Address - Street 1:6949 GOOD SAMARITAN DRIVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247
Mailing Address - Country:US
Mailing Address - Phone:513-931-2400
Mailing Address - Fax:513-931-0132
Practice Address - Street 1:6949 GOOD SAMARITAN DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247
Practice Address - Country:US
Practice Address - Phone:513-931-2400
Practice Address - Fax:513-931-0132
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRIHEALTH PHYSICIANS ENTERPRISE CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2637239Medicaid
OH2637239Medicaid