Healthcare Provider Details

I. General information

NPI: 1962045625
Provider Name (Legal Business Name): UOFL HEALTH-LOUISVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4912 US HIGHWAY 42 STE 104
LOUISVILLE KY
40222-6357
US

IV. Provider business mailing address

530 S JACKSON ST
LOUISVILLE KY
40202-1675
US

V. Phone/Fax

Practice location:
  • Phone: 502-429-8640
  • Fax:
Mailing address:
  • Phone: 502-562-4004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: THOMAS DANIEL MILLER
Title or Position: CEO
Credential:
Phone: 502-562-4004