Provider Demographics
NPI:1598819724
Name:PULMONARY SPECIALISTS OF LOUISVILLE, PSC
Entity Type:Organization
Organization Name:PULMONARY SPECIALISTS OF LOUISVILLE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALMASALKHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-587-9140
Mailing Address - Street 1:3 AUDUBON PLAZA DR STE 620
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40217-1362
Mailing Address - Country:US
Mailing Address - Phone:502-587-9140
Mailing Address - Fax:502-587-9142
Practice Address - Street 1:3 AUDUBON PLAZA DR STE 620
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217
Practice Address - Country:US
Practice Address - Phone:502-587-9140
Practice Address - Fax:502-587-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1048786OtherPASSPORT
KY65918922Medicaid
KY1048786OtherPASSPORT
KY1048786OtherPASSPORT
IN100029140AMedicaid