Organization
PEDIATRIC ACUTE CARE PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRICIA NIENDAM (CREDENTIALLING)
(502) 896-2500
Entity
Organization
Contact information
Practice address
3793 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1044
(502) 896-2500
(502) 896-2527
Mailing address
3793 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1044
(502) 896-2500
(502) 896-2527
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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