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NPI Code Detail

MEDICARE: LOUISVILLE OPTOMETRIC CENTERS III, PSC

MEDICARE: LOUISVILLE OPTOMETRIC CENTERS III, PSC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332H00000XEyewear Supplier
2152W00000XOptometrist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134111271
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOUISVILLE OPTOMETRIC CENTERS III, PSC
Provider Business Mailing Address
First Line : 4000 POPLAR LEVEL RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40213-1524
Country : US
Telephone Number : 502-451-0332
Fax Number : 502-456-9121
Provider Business Practice Location Address
First Line : 4000 POPLAR LEVEL RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40213-1524
Country : US
Telephone Number : 502-451-0332
Fax Number : 502-456-9121
Authorized Official
Title or Position : PRESIDENT OD OWNER
Name : ROD RALLO
Credential : OD
Telephone Number : 502-459-2020
Provider Enumeration Date : 08/16/2005
Last Update Date : 04/19/2022

Similar Medicare Providers

1831181973 — DR. ROD RALLO OD
Practice Location Address:
4000 POPLAR LEVEL RD
LOUISVILLE, KY
40213-1524
Practice Phone: 502-459-2020
Practice Fax: 502-456-5925
1205828357 — DR. BETH ANNE MINTON OD
Practice Location Address:
4000 POPLAR LEVEL RD
LOUISVILLE, KY
40213-1524
Practice Phone: 502-459-2020
Practice Fax: 502-456-5925
1730129537 — DR. NICHOLAS SILVESTROS OD
Practice Location Address:
4000 POPLAR LEVEL RD
LOUISVILLE, KY
40213-1524
Practice Phone: 502-459-2020
Practice Fax: 24-569-1215
1669545554 — LOUISVILLE OPTOMETRIC CENTERS, III PSC
Practice Location Address:
4000 POPLAR LEVEL RD
LOUISVILLE, KY
40213-1524
Practice Phone: 502-459-2020
Practice Fax: 502-456-9121
1487702437 — LOUISVILLE OPTOMETRIC CENTERS, III
Practice Location Address:
4000 POPLAR LEVEL RD
LOUISVILLE, KY
40213-1524
Practice Phone: 502-459-2020
Practice Fax: 502-456-9121
1598020422 — DR. JOSEPH MICHAEL HAMMOND O.D.
Practice Location Address:
4000 POPLAR LEVEL RD
LOUISVILLE, KY
40213-1524
Practice Phone: 502-459-2020
Practice Fax: 502-456-9121

Directions to “LOUISVILLE OPTOMETRIC CENTERS III, PSC ” Practice Location

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