Provider Demographics
NPI:1477760742
Name:PEDIATRICS WITH CARE
Entity Type:Organization
Organization Name:PEDIATRICS WITH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:PELLILLO KUHN
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:502-807-7008
Mailing Address - Street 1:PO BOX 88
Mailing Address - Street 2:
Mailing Address - City:HILLVIEW
Mailing Address - State:KY
Mailing Address - Zip Code:40129-0088
Mailing Address - Country:US
Mailing Address - Phone:502-807-7008
Mailing Address - Fax:502-957-0388
Practice Address - Street 1:4630 SPRINGFIELD CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40229-4526
Practice Address - Country:US
Practice Address - Phone:502-807-7008
Practice Address - Fax:502-957-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR0915174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty