Organization
KENTUCKIANA PAIN SPECIALISTS PSC
Active
Parent organization
KENTUCKIANA PAIN SPECIALISTS PSC
Organization subpart
Yes
Provider details
NPI number
Legal business name
KENTUCKIANA PAIN SPECIALISTS PSC
Authorized official
AJITH NAIR MD (MEDICAL DIRECTOR)
(502) 995-4004
Entity
Organization
Contact information
Practice address
3710 CHAMBERLAIN LN STE A, LOUISVILLE, KY 40241-2002
(502) 995-4004
(502) 933-5559
Mailing address
PO BOX 24261, LOUISVILLE, KY 40224-0261
(502) 299-4004
(502) 933-5559
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100495680
—
KY
Enumeration date
03/22/2021
Last updated
12/01/2021
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