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Contact Information

INTERVENTIONAL REHABILITATION OF KENTUCKY, P.S.C
315 E BROADWAY
SUITE 250
LOUISVILLE, KY40202-3700
 Phone: 502-589-4765
 Fax: 502-589-4799
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
Indicates primary specialty

NPI Profile & details for INTERVENTIONAL REHABILITATION OF KENTUCKY, P.S.C

NPI Number 1275549842
LBN Legal business name INTERVENTIONAL REHABILITATION OF KENTUCKY, P.S.C
Authorized official RICKY COLLIS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/01/2006
Last updated 07/28/2015 - About 11 years ago
Identifiers
IN Medicaid 200279470A
KY Medicaid 1103005
KY Medicaid 65943870
Other 2322033 AETNA
Other 372286700 OWCP
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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