Provider Demographics
NPI:1609061639
Name:1003 INVESTMENTS, LLC
Entity Type:Organization
Organization Name:1003 INVESTMENTS, LLC
Other - Org Name:ULTRASOUND OF AMERICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RT (R)
Authorized Official - Phone:502-500-6648
Mailing Address - Street 1:9120 S COUNTY ROAD 800 W
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47334-9421
Mailing Address - Country:US
Mailing Address - Phone:502-500-6648
Mailing Address - Fax:502-297-8103
Practice Address - Street 1:4500 BOWLING BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-5147
Practice Address - Country:US
Practice Address - Phone:502-500-6648
Practice Address - Fax:502-297-8103
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWEST RADIOLOGY OF KENTUCKY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-09-12
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY720296261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9383101Medicare PIN