Provider Demographics
NPI:1275291759
Name:UNIVERSITY OF KENTUCKY
Entity Type:Organization
Organization Name:UNIVERSITY OF KENTUCKY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OF PAYER ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:DEBORD
Authorized Official - Last Name:YOUNCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-257-9521
Mailing Address - Street 1:2317 ALUMNI PARK PLZ STE 150
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4291
Mailing Address - Country:US
Mailing Address - Phone:859-257-9521
Mailing Address - Fax:859-257-1773
Practice Address - Street 1:245 FOUNTAIN CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1888
Practice Address - Country:US
Practice Address - Phone:833-333-8579
Practice Address - Fax:859-257-3828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNIVERSITY OF KENTUCKY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy