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Organization
LOUISVILLE ENDOSCOPY CENTER, PLLC
Active
Organization
LOUISVILLE ENDOSCOPY CENTER, PLLC
Active
Other names
Louisville Endoscopy Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY SNODGRASS (PRESIDENT)
(615) 665-1283
Entity
Organization
Contact information
Practice address
1400 POPLAR LEVEL RD, SUITE 2, LOUISVILLE, KY 40217-1309
(502) 636-2003
(502) 636-4032
Mailing address
1A BURTON HILLS BLVD, ATTN: L&C, NASHVILLE, TN 37215-6103
(615) 665-1283
(615) 234-1720
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300132
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200411570A
—
IN
01
—
2437243000
PASSPORT ADVANTAGE
KY
05
—
2437243000
—
KY
05
—
36001055
—
KY
Enumeration date
02/07/2006
Last updated
04/22/2022
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