Provider Demographics
NPI:1235271081
Name:KINDRED HOSPITAL LOUISVILLE
Entity Type:Organization
Organization Name:KINDRED HOSPITAL LOUISVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-627-1100
Mailing Address - Street 1:1313 SAINT ANTHONY PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40204-1740
Mailing Address - Country:US
Mailing Address - Phone:502-627-1100
Mailing Address - Fax:
Practice Address - Street 1:1313 SAINT ANTHONY PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40204-1740
Practice Address - Country:US
Practice Address - Phone:502-627-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65902959Medicaid
000000355124OtherANTHEM BCBS
50005946OtherPASSPORT
DB2622OtherRAILROAD MEDICARE
KY65902959Medicaid