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Organization
LOUISVILLE PULMONARY ASSOCIATES, PSC
Active
Organization
LOUISVILLE PULMONARY ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACY LOUISE RALSTON CCPC, LMR (PRACTICE MANAGER)
(502) 368-9590
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 305, LOUISVILLE, KY 40215-1190
(502) 368-9590
(502) 368-9616
Mailing address
4402 CHURCHMAN AVE, SUITE 305, LOUISVILLE, KY 40215-1190
(502) 368-9590
(502) 368-9616
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22609
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2432231000
PASSPORT ADVANTAGE
—
01
—
CM5707
RR MEDICARE
—
Enumeration date
02/03/2006
Last updated
10/09/2007
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