Provider Demographics
NPI:1700386919
Name:COMMUNITY FIRST INJURY CARE, INC
Entity Type:Organization
Organization Name:COMMUNITY FIRST INJURY CARE, INC
Other - Org Name:COMMUNITY FIRST WORX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WAVY
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:SHAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-420-8062
Mailing Address - Street 1:PO BOX 32113
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40232-2113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13806 LAKE POINT CIR STE 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4223
Practice Address - Country:US
Practice Address - Phone:502-405-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine