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General NPI Number Information
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NPI Number | 1629075825
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC
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Dates
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Enumeration Date | 07/01/2005
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 615 S PRESTON ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1715
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Country | US
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Telephone | 502-852-5757
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Fax | 502-852-4039
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Provider Business Mailing Address
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Address Line | 615 S PRESTON ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1715
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Country | US
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Telephone | 502-852-5757
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Fax | 502-852-4039
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Authorized Official
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Title or Position | CHIEF, DIVISION OF NEPHROLOGY
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Name | DR. ELEANOR D LEDERER
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Credential | M.D.
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Telephone | 502-852-5757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number | 182501
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License Number State | KY
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