Provider Demographics
NPI:1598855587
Name:EYE SPECIALISTS OF LOUISVILLE, PSC
Entity Type:Organization
Organization Name:EYE SPECIALISTS OF LOUISVILLE, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-852-5455
Mailing Address - Street 1:301 E MUHAMMAD ALI BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1511
Mailing Address - Country:US
Mailing Address - Phone:502-852-5466
Mailing Address - Fax:502-852-8550
Practice Address - Street 1:301 E MUHAMMAD ALI BLVD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1511
Practice Address - Country:US
Practice Address - Phone:502-852-5466
Practice Address - Fax:502-852-8550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EYE SPECIALISTS OF LOUISVILLE, PSC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-13
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4703940001Medicare NSC