# LOUISVILLE PULMONARY ASSOCIATES, PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336111376
- **Authorized official:** MRS. STACY LOUISE RALSTON CCPC, LMR (PRACTICE MANAGER)
- **Authorized official phone:** (502) 368-9590

## Contact information

- **Practice address:** 4402 CHURCHMAN AVE, SUITE 305, LOUISVILLE, KY 40215-1190
- **Practice address phone:** (502) 368-9590
- **Practice address fax:** (502) 368-9616
- **Mailing address:** 4402 CHURCHMAN AVE, SUITE 305, LOUISVILLE, KY 40215-1190
- **Mailing address phone:** (502) 368-9590
- **Mailing address fax:** (502) 368-9616

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 22609 | KY | Yes |

## Other

- **Enumeration date:** 02/03/2006
- **Last updated:** 10/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2432231000 | PASSPORT ADVANTAGE | — |
| 01 | — | CM5707 | RR MEDICARE | — |