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General NPI Number Information
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NPI Number | 1760705537
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Entity Type | Organization
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Legal Business Name | H. FRED PREUSS, JR.
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Dates
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Enumeration Date | 03/09/2010
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Last Update Date | 10/11/2013
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Provider Practice Location Address
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Address Line | 6323 BARDSTOWN RD
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City | LOUISVILLE
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State | KY
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Zip | 40291-3038
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Country | US
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Telephone | 502-231-1206
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Fax |
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Provider Business Mailing Address
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Address Line | 3684 HIGHWAY 150 SUITE 3
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City | FLOYDS KNOBS
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State | IN
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Zip | 47119-9692
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Country | US
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Telephone | 812-923-9837
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MATT BURTON
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Credential |
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Telephone | 812-923-9837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 00188
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License Number State | KY
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