Provider Demographics
NPI:1740322403
Name:LOUISVILLE JEFFERSON COUNTY METRO
Entity type:Organization
Organization Name:LOUISVILLE JEFFERSON COUNTY METRO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER II
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:KRING
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:502-574-8430
Mailing Address - Street 1:PO BOX 1704
Mailing Address - Street 2:400 EAST GRAY STREET
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1704
Mailing Address - Country:US
Mailing Address - Phone:502-574-5652
Mailing Address - Fax:502-574-6417
Practice Address - Street 1:1215 SOUTH THIRD STREET
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203
Practice Address - Country:US
Practice Address - Phone:502-574-6375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
F140276Medicare ID - Type Unspecified