Provider Demographics
NPI:1750572129
Name:THE OUTPATIENT CONNECTION, LLC
Entity type:Organization
Organization Name:THE OUTPATIENT CONNECTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:CASSARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-891-8940
Mailing Address - Street 1:5518 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9370
Mailing Address - Country:US
Mailing Address - Phone:502-228-0409
Mailing Address - Fax:502-228-3664
Practice Address - Street 1:337 QUARTERMASTER COURT
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130
Practice Address - Country:US
Practice Address - Phone:502-891-8940
Practice Address - Fax:502-891-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical