MEDICARE: PEARL MEDICAL PRACTICE PLLC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1669841631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEARL MEDICAL PRACTICE PLLC

Provider Business Mailing Address
First Line	:	PO BOX 35294
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40232-5294
Country	:	US
Telephone Number	:	502-456-0494
Fax Number	:	502-456-0496

Provider Business Practice Location Address
First Line	:	2202 BUECHEL AVE STE 105
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-2672
Country	:	US
Telephone Number	:	502-456-0494
Fax Number	:	502-456-0496

Authorized Official
Title or Position	:	OWNER
Name	:	OSAWARU JUDE OMORUYI
Credential	:	MD
Telephone Number	:	502-456-0494

Provider Enumeration Date	:	09/21/2015
Last Update Date	:	01/29/2021

Similar Medicare Providers

1396961967 — DR. OSAWARU JUDE OMORUYI M.D
Practice Location Address:

2202 BUECHEL AVE STE 103
LOUISVILLE, KY
40218-2672

Practice Phone: 502-456-0494
Practice Fax: 502-456-0496

1376865972 — PEARL GERIATRICS AND PALLIATIVE MEDICINE, PSC
Practice Location Address:

2202 BUECHEL AVE STE 105
LOUISVILLE, KY
40218-2672

Practice Phone: 502-456-0494
Practice Fax: 504-456-0496

1174081483 — MEDICAL PRODUCTS GROUP, LLC
Practice Location Address:

2202 BUECHEL AVE STE 101
LOUISVILLE, KY
40218-2672

Practice Phone: 630-462-6770
Practice Fax:

1215544549 — PEARL DIAGNOSTIC LABORATORY, LLC
Practice Location Address:

2202 BUECHEL AVE STE 105D
LOUISVILLE, KY
40218-2672

Practice Phone: 502-814-4074
Practice Fax: 502-814-4073

1972172773 — LOVING HEARTS HOME CARE LLC
Practice Location Address:

2202 BUECHEL AVE STE 103
LOUISVILLE, KY
40218-2672

Practice Phone: 502-814-4111
Practice Fax:

1003652405 — AILYN ARIAS QUIJANO NP
Practice Location Address:

2202 BUECHEL AVE
LOUISVILLE, KY
40218-2672

Practice Phone: 502-456-0494
Practice Fax:

Directions to “PEARL MEDICAL PRACTICE PLLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.