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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