1639687619 NPI number — GOULD'S DISCOUNT MEDICAL INC.

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 1639687619 NPI number — GOULD'S DISCOUNT MEDICAL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GOULD'S DISCOUNT MEDICAL 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:
Provider Other Organization Name Type Code:
6
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:
1639687619
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/12/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3901 DUTCHMANS LN STE 100
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:
40207-4726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-491-2000
Provider Business Mailing Address Fax Number:
502-495-2476

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6802 DIXIE HWY
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:
40258-3914
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-935-1100
Provider Business Practice Location Address Fax Number:
502-495-2476
Provider Enumeration Date:
01/12/2018

Additional Information

Authorized Official

Authorized Official Last Name:
GOULD
Authorized Official First Name:
EDMUND
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PRESIDENT - OWNER - DIRECTOR
Authorized Official Telephone Number:
502-491-2000

Provider Taxonomy Codes

  • Taxonomy code: 332S00000X , with the licence number:  101422 , 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)

  • Identifier: 101422 . This is a "MALA S. FELDMAN - HEARING INSTRUMENTS SPECILAIST" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 101422 . This is a "HEARING INSTRUMENTS SPECILAIST" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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