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Contact Information

UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC
9700 PARK PLAZA AVENUE
SUITE 110
LOUISVILLE, KY40241-2286
 Phone: 502-852-7670
 Fax: 502-852-7743
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Gastroenterology

2080P0206X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC

NPI # 1568790277
LBN Legal business name UNIVERSITY PEDIATRIC GASTROENTEROLOGY, LLC
Authorized official GERARD RABALAIS - (CHAIRMAN)
Entity Organization
Organization subpart 1 No
Enumeration date 11/19/2009
Last updated 11/19/2009 - About 17 years ago
Identifiers
IN Medicaid 200945670
KY Medicaid 7100063520
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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