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General NPI Number Information
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NPI Number | 1881182657
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Entity Type | Organization
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Legal Business Name | HAVE A HEART FOUNDATION INC
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 310 E BROADWAY STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40202-1745
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Country | US
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Telephone | 502-742-0485
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Fax |
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Provider Business Mailing Address
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Address Line | 310 E BROADWAY STE 100
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City | LOUISVILLE
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State | KY
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Zip | 40202-1745
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Country | US
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Telephone | 502-742-0485
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Fax |
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | MICHAEL J IMBURGIA
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Credential | MD
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Telephone | 502-742-0485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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