Healthcare Provider Details

I. General information

NPI: 1912769175
Provider Name (Legal Business Name): UOFL HEALTH-LOUISVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2024
Last Update Date: 01/24/2024
Certification Date: 01/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 W HEBRON LN
SHEPHERDSVILLE KY
40165-7425
US

IV. Provider business mailing address

530 S JACKSON ST
LOUISVILLE KY
40202-1675
US

V. Phone/Fax

Practice location:
  • Phone: 502-955-3018
  • Fax: 502-955-3019
Mailing address:
  • Phone:
  • 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: PRESIDENT
Credential:
Phone: 502-562-4004