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General NPI Number Information
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NPI Number | 1497103147
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Entity Type | Organization
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Legal Business Name | METABOLIC SERVICES LLC
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 1015 S 4TH ST SUITE 202
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City | LOUISVILLE
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State | KY
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Zip | 40203-3207
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Country | US
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Telephone | 502-882-2541
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Fax | 502-584-2432
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Provider Business Mailing Address
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Address Line | 1015 S 4TH ST SUITE 202
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City | LOUISVILLE
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State | KY
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Zip | 40203-3207
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Country | US
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Telephone | 502-882-2541
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Fax | 502-584-2432
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Authorized Official
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Title or Position | CEO
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Name | MARTHA J CHAMBERLAIN
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Credential | PHARMD
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Telephone | 502-882-2541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | P07787
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License Number State | KY
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