1326224817 NPI number — LOUISVILLE VETERANS HOSPITAL

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326224817 NPI number — LOUISVILLE VETERANS HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOUISVILLE VETERANS HOSPITAL
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:
Provider Other Organization Name Type Code:
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:
1326224817
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7416 FALLS RIDGE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40241-6400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-423-8315
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 ZORN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40206-1433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-287-4000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TOLEDO
Authorized Official First Name:
AIDA
Authorized Official Middle Name:
GADDI
Authorized Official Title or Position:
MEDICAL TECHNOLOGIST
Authorized Official Telephone Number:
502-423-8315

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X , with the licence number:  MT(ASCP)081133 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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