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Contact Information

LEXINGTON DIABETIC CENTER PSC
3292 EAGLE VIEW LN
SUITE 210
LEXINGTON, KY40509-2173
 Phone: 859-977-8855
 Fax: 859-977-8856
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Point of Service

305S00000X
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for LEXINGTON DIABETIC CENTER PSC

NPI Number 1356499602
LBN Legal business name LEXINGTON DIABETIC CENTER PSC
Authorized official MICHAEL ALLEN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 01/05/2007
Last updated 01/28/2011 - About 15 years ago
Identifiers
KY License # 39043
KY Medicaid 64094485
KY Medicaid 64313646
KY Medicaid 65946022
Other 000000545010 TG ANTHEM LDC
KY Other P00404838 TG LDC RAILROAD PIN
KY Other DD2844 TG LDC RR GRP
KY Other 1285781682 TOSHA NPI
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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