Organization
LOUISVILLE PULMONARY ASSOCIATES, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STACY LOUISE RALSTON CCPC, LMR (PRACTICE MANAGER)
(502) 368-9590
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE, SUITE 305, LOUISVILLE, KY 40215-1190
(502) 368-9590
(502) 368-9616
Mailing address
4402 CHURCHMAN AVE, SUITE 305, LOUISVILLE, KY 40215-1190
(502) 368-9590
(502) 368-9616
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22609
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2432231000
PASSPORT ADVANTAGE
—
01
—
CM5707
RR MEDICARE
—
Enumeration date
02/03/2006
Last updated
10/09/2007
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