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Contact Information

PEARL GERIATRICS AND PALLIATIVE MEDICINE, PSC
2202 BUECHEL AVE STE 105
LOUISVILLE, KY40218-2672
 Phone: 502-456-0494
 Fax: 504-456-0496
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Family

363LF0000X 50 Nurse Practitioner
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PEARL GERIATRICS AND PALLIATIVE MEDICINE PSC · (Female)

NPI # 1376865972
Status Active
Credentials
Entity Individual
Enumeration date 02/23/2010
Last updated 01/29/2021 - About 5 years ago
Sole proprietor 1 Not specified
Identifiers
  • KY License # 3006777
  • KY License # 39870
  • KY Medicaid 7100134680
  • KY Medicaid 7100159350
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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