Provider Demographics
NPI:1023358058
Name:UNIVERSITY OF KENTUCKY HOSPITAL
Entity Type:Organization
Organization Name:UNIVERSITY OF KENTUCKY HOSPITAL
Other - Org Name:DANCEBLUE PEDIATRIC HEMATOLOGY/ONCOLOGY CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:MICHAELS
Authorized Official - Suffix:
Authorized Official - Credentials:CSW, CIA
Authorized Official - Phone:859-257-0537
Mailing Address - Street 1:740 S LIMESTONE
Mailing Address - Street 2:KY CLINIC J 420
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0284
Mailing Address - Country:US
Mailing Address - Phone:859-257-2470
Mailing Address - Fax:859-323-5971
Practice Address - Street 1:740 S LIMESTONE
Practice Address - Street 2:KY CLINIC J 420
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0284
Practice Address - Country:US
Practice Address - Phone:859-257-2470
Practice Address - Fax:859-323-5971
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENUTCKY CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-28
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3728261QM2500X, 282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No282NC2000XHospitalsGeneral Acute Care HospitalChildren