1639791122 NPI number — DR. COLBY RACHEL LOEW MD

Table of content: DR. COLBY RACHEL LOEW MD (NPI 1639791122)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639791122 NPI number — DR. COLBY RACHEL LOEW MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOEW
Provider First Name:
COLBY
Provider Middle Name:
RACHEL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1639791122
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/02/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 ABRAHAM FLEXNER WAY
Provider Second Line Business Mailing Address:
RUDD HEART & LUNG CTR., STE. 690
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-852-0132
Provider Business Mailing Address Fax Number:
502-852-4944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 S PRESTON ST RM 305
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:
40202-1702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-852-8696
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2020

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X , 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)





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