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Contact Information

CPO PSC
4402 CHURCHMAN AVE
SUITE 404
LOUISVILLE, KY40215-1190
 Phone: 502-363-4156
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CPO PSC

NPI # 1720090525
LBN Legal business name CPO PSC
Authorized official LAWRENCE PETERS - (MD)
Entity Organization
Organization subpart 1 No
Enumeration date 08/12/2006
Last updated 05/27/2022 - About 4 years ago
Identifiers
KY License # 31716
KY License # 5222
KY Medicaid 65900961
KY Medicaid 78903531
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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