MEDICARE: NORDIC HEALTHCARE, LLC

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
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1336931575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORDIC HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	8300 VAUGHN MILL RD
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40228-2330
Country	:	US
Telephone Number	:	502-999-2271
Fax Number	:

Provider Business Practice Location Address
First Line	:	2257 EXECUTIVE DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40505-4809
Country	:	US
Telephone Number	:	502-999-2271
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	CHRISTOPHER WAYNE JONES
Credential	:
Telephone Number	:	502-999-2271

Provider Enumeration Date	:	05/22/2025
Last Update Date	:	05/22/2025

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