Provider Demographics
NPI:1497103147
Name:METABOLIC SERVICES LLC
Entity Type:Organization
Organization Name:METABOLIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:502-882-2541
Mailing Address - Street 1:1015 S 4TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203-3207
Mailing Address - Country:US
Mailing Address - Phone:502-882-2541
Mailing Address - Fax:502-584-2432
Practice Address - Street 1:1015 S 4TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-3207
Practice Address - Country:US
Practice Address - Phone:502-882-2541
Practice Address - Fax:502-584-2432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYP07787333600000X
332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Yes333600000XSuppliersPharmacy