Healthcare Provider Details

I. General information

NPI: 1467606418
Provider Name (Legal Business Name): CHILTON CAPITOL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 11/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 WEST BROADWAY SUITE 902
LOUISVILLE KY
40202
US

IV. Provider business mailing address

332 WEST BROADWAY SUITE 902
LOUISVILLE KY
40202
US

V. Phone/Fax

Practice location:
  • Phone: 502-690-2648
  • Fax: 502-690-2653
Mailing address:
  • Phone: 502-690-2648
  • Fax: 502-690-2653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. STEPHEN M CHILTON
Title or Position: DIRECTOR
Credential:
Phone: 502-690-2648