Provider Demographics
NPI:1083609598
Name:MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:MEDICAL SERVICES, INC.
Other - Org Name:GLASGOW KIDNEY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJANATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARALAKULASINGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-458-6359
Mailing Address - Street 1:4114 BROWNS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1534
Mailing Address - Country:US
Mailing Address - Phone:502-458-6359
Mailing Address - Fax:502-459-8626
Practice Address - Street 1:205 PROFESSIONAL PARK DR
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-3486
Practice Address - Country:US
Practice Address - Phone:270-651-7776
Practice Address - Fax:270-651-3495
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-12
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY300095174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000054872OtherANTHEM
KY39090279Medicaid
KY000000054872OtherANTHEM