Provider Demographics
NPI:1952623944
Name:BASEM ATTUM
Entity Type:Organization
Organization Name:BASEM ATTUM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WELSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-852-6902
Mailing Address - Street 1:6315 INNISBROOK DR
Mailing Address - Street 2:
Mailing Address - City:PROSPECT
Mailing Address - State:KY
Mailing Address - Zip Code:40059-9285
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6315 INNISBROOK DR
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-9285
Practice Address - Country:US
Practice Address - Phone:502-797-8833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-18
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.016873282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital