Provider Demographics
NPI:1841491008
Name:BARDSTOWN WOMENS HEALTH CARE LLC
Entity type:Organization
Organization Name:BARDSTOWN WOMENS HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BASIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHLEIFEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-348-8100
Mailing Address - Street 1:118 PATRIOT DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004
Mailing Address - Country:US
Mailing Address - Phone:502-348-8100
Mailing Address - Fax:
Practice Address - Street 1:118 PATRIOT DRIVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004
Practice Address - Country:US
Practice Address - Phone:502-348-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY36376207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64033657Medicaid
KY64033657Medicaid
KYH81667Medicare UPIN