Healthcare Provider Details
I. General information
NPI: 1891338554
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: 01/09/2020
Certification Date: 01/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1905 W HEBRON LN STE 106
SHEPHERDSVILLE KY
40165-7466
US
IV. Provider business mailing address
530 S JACKSON ST
LOUISVILLE KY
40202-1675
US
V. Phone/Fax
- Phone: 502-955-7705
- Fax:
- Phone: 502-681-1480
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273Y00000X |
| Taxonomy | Rehabilitation Hospital Unit |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THOMAS
DANIEL
MILLER
Title or Position: CEO
Credential:
Phone: 502-562-4004