Organization
LOUISVILLE OPTOMETRIC CENTERS, III PSC
Active
Other names
VisionFirst
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROD L. RALLO O.D. (OWNER)
(502) 459-2020
Entity
Organization
Contact information
Practice address
2110 S HURSTBOURNE PKWY, LOUISVILLE, KY 40220-1622
(502) 491-2232
(502) 499-2700
Mailing address
2110 S HURSTBOURNE PKWY, LOUISVILLE, KY 40220-1622
(502) 499-5544
(502) 499-2700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
843DT
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77903789
MEDICAID EPSDT
KY
05
—
77903789
—
KY
Enumeration date
01/08/2007
Last updated
02/19/2014
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