MEDICARE: UOFL HEALTH-LOUISVILLE 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
1	261QR0400X	Rehabilitation Clinic/Center
2	273Y00000X	Rehabilitation Hospital Unit

General Provider Information

NPI Number	:	1891338554
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UOFL HEALTH-LOUISVILLE INC

Provider Business Mailing Address
First Line	:	530 S JACKSON ST
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1675
Country	:	US
Telephone Number	:	502-681-1480
Fax Number	:

Provider Business Practice Location Address
First Line	:	1905 W HEBRON LN STE 106
Second Line	:
City	:	SHEPHERDSVILLE
State	:	KY
Zip	:	40165-7466
Country	:	US
Telephone Number	:	502-955-7705
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	THOMAS DANIEL MILLER
Credential	:
Telephone Number	:	502-562-4004

Provider Enumeration Date	:	10/24/2019
Last Update Date	:	01/09/2020

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