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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

NPI Number 1376865972
LBN Legal business name PEARL GERIATRICS AND PALLIATIVE MEDICINE, PSC
Authorized official OSAWARU OMORUYI - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/23/2010
Last updated 01/29/2021 - About 5 years ago
Identifiers
KY License # 3006777
KY License # 39870
KY Medicaid 7100134680
KY Medicaid 7100159350
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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