Provider Demographics
NPI:1255816997
Name:LOUISVILLE FAMILY AUDIOLOGY AND HEARING AID CENTER LLC
Entity type:Organization
Organization Name:LOUISVILLE FAMILY AUDIOLOGY AND HEARING AID CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-893-3342
Mailing Address - Street 1:4003 KRESGE WAY STE 227
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4652
Mailing Address - Country:US
Mailing Address - Phone:502-893-3342
Mailing Address - Fax:
Practice Address - Street 1:4003 KRESGE WAY STE 225
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-893-3342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-28
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Single Specialty