1780756312 NPI number — CITY OF LOUISVILLE

Table of content: (NPI 1780756312)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780756312 NPI number — CITY OF LOUISVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF LOUISVILLE
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:
1780756312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/31/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 S MILL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44641-1665
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-875-3434
Provider Business Mailing Address Fax Number:
330-875-9091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 S MILL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44641-1665
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-875-3321
Provider Business Practice Location Address Fax Number:
330-875-9091
Provider Enumeration Date:
11/15/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ARNTZ-TOURNOUX
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
TAX ADMINISTRATOR
Authorized Official Telephone Number:
330-875-3434

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  02-0316400 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 020316400 . This is a "BOARD OF PHARMACY" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0980550 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000155992 . This is a "BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".