Organization
PULMONARY CARE SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MHD HAITHAM CHAKER MD (OWNER)
(502) 633-1151
Entity
Organization
Contact information
Practice address
720 HOSPITAL DR, STE 106, SHELBYVILLE, KY 40065-1685
(502) 633-1151
Mailing address
720 HOSPITAL DR, STE 106, SHELBYVILLE, KY 40065-1685
(502) 633-1151
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35377
KY
207RP1001X
Pulmonary Disease Physician
Primary
35377
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000901376
BCBS
KY
01
—
9870
HUMANA
KY
Enumeration date
10/23/2014
Last updated
03/19/2015
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