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Organization

PMR KY HOLDING, LLC

Active
Parent organization
PMR KY HOLDING, LLC
Other names
Jencare Neighborhood Medical Center Shivley, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PMR KY HOLDING, LLC
Authorized official
MARY CHEN (EXECUTIVE OFFICER)
(305) 628-6117
Entity
Organization

Contact information

Practice address
3939 7TH STREET RD, LOUISVILLE, KY 40216-4103
(502) 775-1211
(502) 775-1221
Mailing address
1395 NW 167TH ST, MIAMI GARDENS, FL 33169-5710
(305) 628-6117

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
332900000X
Non-Pharmacy Dispensing Site
3336C0003X
Community/Retail Pharmacy
Primary

Other

Enumeration date
09/12/2018
Last updated
07/24/2023
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