1487758983 NPI number — SCHEEN & SMITH, P.S.C.

Table of content: (NPI 1487758983)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487758983 NPI number — SCHEEN & SMITH, P.S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHEEN & SMITH, P.S.C.
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:
1487758983
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3950 KRESGE WAY
Provider Second Line Business Mailing Address:
SUITE 305
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40207-4637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-896-8803
Provider Business Mailing Address Fax Number:
502-896-8863

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3950 KRESGE WAY
Provider Second Line Business Practice Location Address:
SUITE 305
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40207-4637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-896-8803
Provider Business Practice Location Address Fax Number:
502-896-8863
Provider Enumeration Date:
09/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
Z
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
502-896-8803

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  17338 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ND0900X , with the licence number: 17338 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207NS0135X , with the licence number: 17338 , 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: 64173388 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000046994 . This is a "BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 1066659 . This is a "PASSPORT" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2434641000 . This is a "PASSPORT ADVANTAGE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: CB7118 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".