1760632624 NPI number — KENTUCKY MEDICAL SERVICES FOUNDATION

Table of content: (NPI 1760632624)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760632624 NPI number — KENTUCKY MEDICAL SERVICES FOUNDATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KENTUCKY MEDICAL SERVICES FOUNDATION
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:
UNIVERISTY OF KENTUCKY DEPARTMENT OF INTERNAL MEDICINE
Provider Other Organization Name Type Code:
5
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:
1760632624
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2333 ALUMNI PARK PLZ
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
LEXINGTON
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40536-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-257-7910
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
740 S LIMESTONE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40536-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-257-7910
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KARPF
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
EVPHO
Authorized Official Telephone Number:
859-257-7910

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 65912255 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".