Healthcare Provider Details

I. General information

NPI: 1134387228
Provider Name (Legal Business Name): HEART MATTERS PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

789 EASTERN BY PASS STE 20, MOB 1
RICHMOND KY
40475-2421
US

IV. Provider business mailing address

789 EASTERN BY PASS STE 20, MOB 1
RICHMOND KY
40475-2421
US

V. Phone/Fax

Practice location:
  • Phone: 859-625-5511
  • Fax: 859-625-5513
Mailing address:
  • Phone: 859-625-5511
  • Fax: 859-625-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: REGINA ROWLAND
Title or Position: OFFICE MANAGER
Credential:
Phone: 859-625-5511