Provider Demographics
NPI:1386832079
Name:LUXURY BATH & KITCHEN OF LOUISVILLE, INC.
Entity Type:Organization
Organization Name:LUXURY BATH & KITCHEN OF LOUISVILLE, INC.
Other - Org Name:LUXURY BATH SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:JACK
Authorized Official - Last Name:TANNEHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-262-0418
Mailing Address - Street 1:2010 NORTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6321
Mailing Address - Country:US
Mailing Address - Phone:502-262-0418
Mailing Address - Fax:502-742-3519
Practice Address - Street 1:946 GOSS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1234
Practice Address - Country:US
Practice Address - Phone:502-452-8827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies