Organization
PREMIER SURGERY CENTER OF LOUISVILLE LP
Active
Other names
Premier Surgery Center of Louisville
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY BROCK (CHIEF ADMINISTRATIVE OFFICER)
(502) 589-9488
Entity
Organization
Contact information
Practice address
2511 TERRA CROSSING BLVD, LOUISVILLE, KY 40245-5375
(502) 589-9488
(502) 254-3901
Mailing address
2511 TERRA CROSSING BLVD, LOUISVILLE, KY 40245-5375
(502) 589-9488
(502) 254-3901
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
300044
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36000891
—
KY
Enumeration date
04/26/2006
Last updated
10/24/2019
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