Provider Demographics
NPI:1720790223
Name:INFINITY CARE
Entity Type:Organization
Organization Name:INFINITY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:PICKFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-293-7377
Mailing Address - Street 1:2515 7TH STREET RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-1070
Mailing Address - Country:US
Mailing Address - Phone:585-402-9286
Mailing Address - Fax:502-632-1432
Practice Address - Street 1:2515 7TH STREET RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40208-1070
Practice Address - Country:US
Practice Address - Phone:585-402-9286
Practice Address - Fax:502-632-1432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-16
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1861867830OtherNPI