# UNIVERSITY PEDIATRIC BONE MARROW TRANSPLANT SPECIALISTS, LLC

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

## Provider details

- **NPI number:** 1922386143
- **Authorized official:** DR. GERARD P RABALAIS MD (CHAIRMAN)
- **Authorized official phone:** (502) 852-8600

## Contact information

- **Practice address:** 601 S FLOYD ST, STE. 403, LOUISVILLE, KY 40202-1835
- **Practice address phone:** (502) 629-7750
- **Practice address fax:** (502) 629-7784
- **Mailing address:** PO BOX 2469, LOUISVILLE, KY 40201-2469
- **Mailing address phone:** (502) 852-8500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | NULL | Yes |
| 2080P0207X | Pediatric Hematology & Oncology Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | NULL | — |
| 363LP0200X | Pediatric Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/22/2011
- **Last updated:** 07/22/2011