Organization
UNIVERSITY OF LOUISVILLE RESEARCH FOUNDATION, INC
Active
Other names
Kidney Disease Program / Louisville Renal Dialysis Facility
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELEANOR D LEDERER M.D. (CHIEF, DIVISION OF NEPHROLOGY)
(502) 852-5757
Entity
Organization
Contact information
Practice address
615 S PRESTON ST, LOUISVILLE, KY 40202-1715
(502) 852-5757
(502) 852-4039
Mailing address
615 S PRESTON ST, LOUISVILLE, KY 40202-1715
(502) 852-5757
(502) 852-4039
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
182501
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000112462
BCBS 12 DIGIT PROVIDER #
KY
01
—
000003108H
HUMANA HEALTH CARE NUMBER
KY
01
—
004541476
AETNA PROVIDER #
KY
01
—
100003040A
INDIANA MEDICAID
IN
01
—
350
BLUE CROSS NUMBER
KY
05
—
39090030
—
KY
05
—
50001023
—
KY
01
—
5416V4981
AHDS PROVIDER #
KY
Enumeration date
07/01/2005
Last updated
10/07/2011
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