1457406019 NPI number — ANTHONY R UY LLC

Table of content: (NPI 1457406019)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457406019 NPI number — ANTHONY R UY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANTHONY R UY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BLUEGRASS OBSTETRICS, GYNECOLOGY, AND INFERTILITY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457406019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
355 LANGDON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOMERSET
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42503-2792
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-679-8391
Provider Business Mailing Address Fax Number:
606-678-4033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
355 LANGDON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42503-2792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-679-8391
Provider Business Practice Location Address Fax Number:
606-678-4033
Provider Enumeration Date:
01/24/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
UY
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
606-679-8391

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LX0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7100049590 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".