Organization
PRO2 LOUISVILLE, LLC
Active
Other names
PRO2 Respiratory Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D. MOORE RRT (EVP)
(502) 962-4704
Entity
Organization
Contact information
Practice address
4616 POPLAR LEVEL RD, LOUISVILLE, KY 40213-2338
(502) 962-4704
(502) 962-4760
Mailing address
4616 POPLAR LEVEL RD, LOUISVILLE, KY 40213-2338
(502) 962-4704
(502) 962-4760
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
MG0493
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
90012162
—
KY
Enumeration date
12/19/2006
Last updated
05/21/2008
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