Provider Demographics
NPI:1760979124
Name:HEALTHY LIVING PRIMARY CARE
Entity Type:Organization
Organization Name:HEALTHY LIVING PRIMARY CARE
Other - Org Name:HEALTHY LIVING HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHNUKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-938-4715
Mailing Address - Street 1:4400 BRECKENRIDGE LN STE 147
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-4175
Mailing Address - Country:US
Mailing Address - Phone:502-243-7383
Mailing Address - Fax:800-214-6418
Practice Address - Street 1:4400 BRECKENRIDGE LN STE 147
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218
Practice Address - Country:US
Practice Address - Phone:502-243-7383
Practice Address - Fax:800-214-6418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-20
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care