MEDICARE: UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION

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	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1932465655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION

Provider Business Mailing Address
First Line	:	PO BOX 909
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40201-0909
Country	:	US
Telephone Number	:	502-588-0320
Fax Number	:	502-588-0326

Provider Business Practice Location Address
First Line	:	500 S PRESTON ST
Second Line	:	BUILDING 55B, ROOM 126
City	:	LOUISVILLE
State	:	KY
Zip	:	40202-1702
Country	:	US
Telephone Number	:	502-852-5865
Fax Number	:	502-852-5782

Authorized Official
Title or Position	:	CFO
Name	:	JONATHON ARRINGTON
Credential	:
Telephone Number	:	502-588-0301

Provider Enumeration Date	:	04/06/2012
Last Update Date	:	04/06/2012

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