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General NPI Number Information
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NPI Number | 1508696576
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Entity Type | Organization
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Legal Business Name | NETTRANS
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Dates
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Enumeration Date | 08/05/2024
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Last Update Date | 04/27/2025
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Provider Practice Location Address
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Address Line | 8305 SHEPHERDSVILLE RD
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City | LOUISVILLE
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State | KY
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Zip | 40219-4532
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Country | US
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Telephone | 864-372-6664
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Fax |
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Provider Business Mailing Address
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Address Line | 8305 SHEPHERDSVILLE RD
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City | LOUISVILLE
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State | KY
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Zip | 40219-4532
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Country | US
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Telephone | 864-372-6664
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. RAY THOMAS STREETMAN III
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Credential | RN
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Telephone | 864-372-6664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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