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Contact Information

LOUISVILLE RETINA PLLC
1169 EASTERN PKWY STE 3323
LOUISVILLE, KY40217-1415
 Phone: 718-300-1540
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for LOUISVILLE RETINA PLLC

NPI # 1215691308
LBN Legal business name LOUISVILLE RETINA PLLC
Authorized official ANUPA MANDAVA - (MD)
Entity Organization
Organization subpart 1 No
Enumeration date 10/26/2021
Last updated 02/03/2022 - About 4 years ago
Identifiers
KY Medicaid 7100779210
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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