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NPI Code Detail

MEDICARE: UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC

MEDICARE: UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center182501KY

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
3000003108HOTHERKYHUMANA HEALTH CARE NUMBER
4004541476OTHERKYAETNA PROVIDER #
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
65416V4981OTHERKYAHDS PROVIDER #
7000000112462OTHERKYBCBS 12 DIGIT PROVIDER #
8350OTHERKYBLUE CROSS NUMBER

General Provider Information

NPI Number : 1629075825
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC
Provider Business Mailing Address
First Line : 615 S PRESTON ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40202-1715
Country : US
Telephone Number : 502-852-5757
Fax Number : 502-852-4039
Provider Business Practice Location Address
First Line : 615 S PRESTON ST
Second Line :
City : LOUISVILLE
State : KY
Zip : 40202-1715
Country : US
Telephone Number : 502-852-5757
Fax Number : 502-852-4039
Authorized Official
Title or Position : CHIEF, DIVISION OF NEPHROLOGY
Name : DR. ELEANOR D LEDERER
Credential : M.D.
Telephone Number : 502-852-5757
Provider Enumeration Date : 07/01/2005
Last Update Date : 10/07/2011

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