Basic Information
| Provider Information | |||||||||
| NPI: | 1730722406 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UOFL HEALTH-LOUISVILLE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 530 S JACKSON ST | ||||||||
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| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402021675 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025624004 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 CENTRAL AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402081451 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026379313 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2019 | ||||||||
| LastUpdateDate: | 01/09/2020 | ||||||||
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| AuthorizedOfficialLastName: | MILLER | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | DANIEL | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5025624004 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | UOFL HEALTH-LOUISVILLE INC | ||||||||
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| NPICertificationDate: | 01/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | N | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation | 273Y00000X | Y | Hospital Units | Rehabilitation Unit |
No ID Information.