# LIFESCAN OF LOUISVILLE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lifescan Louisville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942203955
- **Authorized official:** MRS. MICHELLE DOUGLAS (CONTRACT MANAGER)
- **Authorized official phone:** (502) 403-1401

## Contact information

- **Practice address:** 4046 DUTCHMANS LN, LOUISVILLE, KY 40207-4712
- **Practice address phone:** (502) 893-7145
- **Practice address fax:** (502) 893-7147
- **Mailing address:** 4046 DUTCHMANS LN, LOUISVILLE, KY 40207-4712
- **Mailing address phone:** (502) 893-7145
- **Mailing address fax:** (502) 893-7147

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 01/11/2012