Healthcare Provider Details

I. General information

NPI: 1568184216
Provider Name (Legal Business Name): UOFL HEALTH-LOUISVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2022
Last Update Date: 02/02/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 BLUEGRASS AVE
LOUISVILLE KY
40215-1161
US

IV. Provider business mailing address

530 S JACKSON ST
LOUISVILLE KY
40202-1675
US

V. Phone/Fax

Practice location:
  • Phone: 502-367-3315
  • Fax: 502-367-3318
Mailing address:
  • Phone: 502-562-4004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

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