Provider Demographics
NPI:1780123463
Name:PBM FRANCHISE GROUP LLC
Entity type:Organization
Organization Name:PBM FRANCHISE GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-523-0192
Mailing Address - Street 1:10610 WATTERSON CENTER CT
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2509
Mailing Address - Country:US
Mailing Address - Phone:502-442-2480
Mailing Address - Fax:502-442-2490
Practice Address - Street 1:10610 WATTERSON CENTER CT
Practice Address - Street 2:SUITE 202
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-2509
Practice Address - Country:US
Practice Address - Phone:502-442-2480
Practice Address - Fax:502-442-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health