Provider Demographics
NPI:1659441897
Name:PAIN MANAGEMENT TECHNOLOGIES INC
Entity Type:Organization
Organization Name:PAIN MANAGEMENT TECHNOLOGIES INC
Other - Org Name:PMT MEDICAL INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFKOVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-564-0817
Mailing Address - Street 1:7100 PRESTON HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-2730
Mailing Address - Country:US
Mailing Address - Phone:502-968-8364
Mailing Address - Fax:502-962-9505
Practice Address - Street 1:7100 PRESTON HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-2730
Practice Address - Country:US
Practice Address - Phone:502-968-8364
Practice Address - Fax:502-962-9505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4338390002Medicare ID - Type Unspecified