Provider Demographics
NPI:1922864719
Name:ASET PRIMARY CARE LLC
Entity Type:Organization
Organization Name:ASET PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENU
Authorized Official - Middle Name:
Authorized Official - Last Name:KASULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-948-6052
Mailing Address - Street 1:129 SAINT MATTHEWS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-3141
Mailing Address - Country:US
Mailing Address - Phone:502-797-8055
Mailing Address - Fax:
Practice Address - Street 1:129 SAINT MATTHEWS AVE STE C
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3141
Practice Address - Country:US
Practice Address - Phone:502-797-8055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty