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General NPI Number Information
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NPI Number | 1053098020
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Entity Type | Organization
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Legal Business Name | SIMPLICITY MONITORING AND DIAGNOSTICS LLC
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 07/18/2023
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Provider Practice Location Address
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Address Line | 104 DAVENTRY LN
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City | LOUISVILLE
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State | KY
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Zip | 40223-2883
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Country | US
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Telephone | 502-445-7957
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Fax |
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Provider Business Mailing Address
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Address Line | 11605 SUN GLOW CT
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City | LOUISVILLE
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State | KY
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Zip | 40272-3883
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Country | US
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Telephone | 502-445-7957
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RAYSHUNALE SMITH
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Credential | NP
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Telephone | 502-445-7957
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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