Organization
UNIVERSITY CHILDREN'S CONSCIOUS SEDATION SPECIALISTS, LLC
Active
Other names
University Children's Sedation Service, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERARD P. RABALAIS M.D. (PRESIDENT)
(502) 852-8500
Entity
Organization
Contact information
Practice address
231 E CHESTNUT STREET, LOUISVILLE, KY 40202-1821
(502) 852-8500
(502) 852-8556
Mailing address
P.O. BOX 2469, LOUISVILLE, KY 40201-2469
(502) 852-8500
(502) 852-8556
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LC0200X
Critical Care Medicine Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200454140A
—
IN
05
—
65940702
—
KY
05
—
78904166
—
KY
Enumeration date
02/26/2007
Last updated
07/09/2012
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