Provider Demographics
NPI:1558463729
Name:FS KENTUCKY ONE LLC
Entity Type:Organization
Organization Name:FS KENTUCKY ONE LLC
Other - Org Name:FOOT SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-897-0096
Mailing Address - Street 1:4151A SHELBYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3202
Mailing Address - Country:US
Mailing Address - Phone:502-897-0096
Mailing Address - Fax:502-897-0776
Practice Address - Street 1:4151A SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3202
Practice Address - Country:US
Practice Address - Phone:502-897-0096
Practice Address - Fax:502-897-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
390973OtherANTHEM
390973OtherANTHEM