1861554438 NPI number — UNIVERSITY MEDICAL CENTER, INC

Table of content: (NPI 1861554438)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861554438 NPI number — UNIVERSITY MEDICAL CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY MEDICAL CENTER, INC
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:
DBA UNIVERSITY OF LOUSIVILLE HOSPITAL
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:
1861554438
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
530 S JACKSON ST
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:
40202-1675
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-562-3634
Provider Business Mailing Address Fax Number:
502-562-3222

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
530 S JACKSON ST
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:
40202-1675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-562-3634
Provider Business Practice Location Address Fax Number:
502-562-3222
Provider Enumeration Date:
12/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAYLOR
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
502-562-4002

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  100220 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X , with the licence number: 100220 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: 100220 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 100220 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: 100220 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , with the licence number: 100220 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 200074320A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 87726 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 60054 . This is a "AETNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2432182000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 01022433 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 517041500 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 61101 . This is a "HUMANA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1048739 . This is a "PASSPORT HEALTH PLAN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 62308 . This is a "CIGNA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000054937 . This is a "BLUE CROSS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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