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NPI Code Detail

MEDICARE: LP LOUISVILLE SOUTH LLC

MEDICARE: LP LOUISVILLE SOUTH LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility100452KY

General Provider Information

NPI Number : 1891986170
Entity Type Code : Organization
Provider Name (Legal Business Name) : LP LOUISVILLE SOUTH LLC
Provider Business Mailing Address
First Line : 12201 BLUEGRASS PKWY
Second Line :
City : LOUISVILLE
State : KY
Zip : 40299-2361
Country : US
Telephone Number : 502-568-7800
Fax Number : 502-568-7150
Provider Business Practice Location Address
First Line : 1120 CRISTLAND RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40214-4150
Country : US
Telephone Number : 502-367-0104
Fax Number : 502-368-5208
Authorized Official
Title or Position : CFO
Name : MR. JOHN HARRISON
Credential :
Telephone Number : 502-568-7800
Provider Enumeration Date : 08/05/2007
Last Update Date : 04/04/2023

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Directions to “LP LOUISVILLE SOUTH LLC ” Practice Location

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