Provider Demographics
NPI:1770338824
Name:ZENITH MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:ZENITH MEDICAL GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SISIC
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:502-415-8349
Mailing Address - Street 1:3924 S DUPONT SQ STE D
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-5912
Mailing Address - Country:US
Mailing Address - Phone:502-415-8349
Mailing Address - Fax:
Practice Address - Street 1:3924 S DUPONT SQ STE D
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-5912
Practice Address - Country:US
Practice Address - Phone:502-415-8349
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care