# LOUISVILLE & SO INDIANA PULMONARY CARE

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

## Provider details

- **NPI number:** 1417366279
- **Authorized official:** STACY L RALSTON (PRACTICE ADMINISTATOR)
- **Authorized official phone:** (502) 368-9561

## Contact information

- **Practice address:** 4402 CHURCHMAN AVE, STE 409, LOUISVILLE, KY 40215-1190
- **Practice address phone:** (502) 368-9561
- **Practice address fax:** (502) 882-1263
- **Mailing address:** 4402 CHURCHMAN AVE, STE 409, LOUISVILLE, KY 40215-1190
- **Mailing address phone:** (502) 368-9561
- **Mailing address fax:** (502) 882-1263

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LC0200X | Critical Care Medicine Nurse Practitioner | 3008801 | KY | Yes |

## Other

- **Enumeration date:** 08/06/2014
- **Last updated:** 08/06/2014