# CPO PSC

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

## Provider details

- **NPI number:** 1720090525
- **Authorized official:** LAWRENCE H PETERS MD (MD)
- **Authorized official phone:** (502) 366-0970

## Contact information

- **Practice address:** 4402 CHURCHMAN AVE, SUITE 404, LOUISVILLE, KY 40215-1190
- **Practice address phone:** (502) 363-4156
- **Mailing address:** PO BOX 30563, BELFAST, ME 04915-2057
- **Mailing address phone:** (888) 488-8289
- **Mailing address fax:** (502) 919-9780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | 31716 | KY | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 31716 | KY | — |
| 363LF0000X | Family Nurse Practitioner | 5222 | KY | — |

## Other

- **Enumeration date:** 08/12/2006
- **Last updated:** 05/27/2022