Organization
THE SPECIAL LADY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLE CRAWLEY COOGLE (PRESIDENT)
(502) 896-6975
Entity
Organization
Contact information
Practice address
4010 DUPONT CIR, SUITE L15, LOUISVILLE, KY 40207-4812
(502) 896-6975
(502) 896-2358
Mailing address
4010 DUPONT CIR, SUITE L15, LOUISVILLE, KY 40207-4812
(502) 896-6975
(502) 896-2358
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000074796
ANTHEM
KY
01
—
1062770
PASSPORT
KY
05
—
90293564
—
KY
Enumeration date
03/08/2007
Last updated
08/22/2020
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