1861621740 NPI number — UNIVERSITY MEDICAL SERVICES FOUNDATION 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 1861621740 NPI number — UNIVERSITY MEDICAL SERVICES FOUNDATION INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY MEDICAL SERVICES FOUNDATION 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:
1861621740
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
501 E BROADWAY
Provider Second Line Business Mailing Address:
STE 220
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-561-8680
Provider Business Mailing Address Fax Number:
502-589-5093

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 S JACKSON ST
Provider Second Line Business Practice Location Address:
3RD FLOOR ACB
Provider Business Practice Location Address City Name:
LOUISVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40202-1622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-561-8680
Provider Business Practice Location Address Fax Number:
502-589-5093
Provider Enumeration Date:
07/13/2009

Additional Information

Authorized Official

Authorized Official Last Name:
SNAWDER
Authorized Official First Name:
TIM
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING DIRECTOR
Authorized Official Telephone Number:
502-589-4856

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X , 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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