Provider Demographics
NPI:1891794962
Name:INPATIENT CARE SPECIALIST, LLC
Entity Type:Organization
Organization Name:INPATIENT CARE SPECIALIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARDYLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAGATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-426-9680
Mailing Address - Street 1:2301 RIVER RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1010
Mailing Address - Country:US
Mailing Address - Phone:502-814-3175
Mailing Address - Fax:502-426-5493
Practice Address - Street 1:2301 RIVER RD
Practice Address - Street 2:SUITE 302
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1010
Practice Address - Country:US
Practice Address - Phone:502-814-3175
Practice Address - Fax:502-426-5493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC17960OtherRAILROAD MEDICARE KY
KY65937211Medicaid
KYC17960OtherRAILROAD MEDICARE KY