Organization
EAST LOUISVILLE INTERVENTIONAL PAIN SPECIALISTS PLLC
Active
Organization
EAST LOUISVILLE INTERVENTIONAL PAIN SPECIALISTS PLLC
Active
Other names
Elips Scripts
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GREEN (MANAGER)
(502) 939-6085
Entity
Organization
Contact information
Practice address
4205 SPRINGHURST BLVD STE 101, LOUISVILLE, KY 40241-6159
(502) 290-7246
Mailing address
3206 WILDWOOD TRL, LA GRANGE, KY 40031-8232
(502) 939-6085
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
P07694
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152529
PK
—
Enumeration date
06/18/2015
Last updated
06/18/2015
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