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General NPI Number Information
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NPI Number | 1669722187
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Entity Type | Organization
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Legal Business Name | SANA PALLIATIVE CARE LLC
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 09/12/2012
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Provider Practice Location Address
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Address Line | 3906 THERINA WAY
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City | LOUISVILLE
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State | KY
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Zip | 40241-1542
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Country | US
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Telephone | 502-744-8785
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Fax |
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Provider Business Mailing Address
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Address Line | 3906 THERINA WAY
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City | LOUISVILLE
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State | KY
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Zip | 40241-1542
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Country | US
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Telephone | 502-744-8785
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. MARION OHAGAN
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Credential | APRN
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Telephone | 502-744-8785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 3007449
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License Number State | KY
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