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General NPI Number Information
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NPI Number | 1609061639
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Entity Type | Organization
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Legal Business Name | 1003 INVESTMENTS, LLC
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 12/29/2011
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Provider Practice Location Address
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Address Line | 4500 BOWLING BLVD SUITE 100
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City | LOUISVILLE
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State | KY
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Zip | 40207-5147
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Country | US
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Telephone | 502-500-6648
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Fax | 502-297-8103
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Provider Business Mailing Address
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Address Line | 9120 S COUNTY ROAD 800 W
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City | DALEVILLE
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State | IN
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Zip | 47334-9421
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Country | US
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Telephone | 502-500-6648
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Fax | 502-297-8103
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | MR. JASON ALLEN TAYLOR
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Credential | R.T. (R)
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Telephone | 502-500-6648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number | 720296
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License Number State | KY
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