Organization
LIFESCAN OF LOUISVILLE LLC
Active
Other names
Lifescan Louisville
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE DOUGLAS (CONTRACT MANAGER)
(502) 403-1401
Entity
Organization
Contact information
Practice address
4046 DUTCHMANS LN, LOUISVILLE, KY 40207-4712
(502) 893-7145
(502) 893-7147
Mailing address
4046 DUTCHMANS LN, LOUISVILLE, KY 40207-4712
(502) 893-7145
(502) 893-7147
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65933764
—
KY
05
—
7100041020
—
KY
Enumeration date
05/23/2005
Last updated
01/11/2012
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