Kentuckiana Center For Addiction Medicine

LBN: A Newco Llc
Kentuckiana Center For Addiction Medicine is an health care organization with primary practice located at 1939 Goldsmith Ln Ste 100 , Louisville KY 40218-3090. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty. A Newco Llc can be contacted via phone (502) 873-7517, or through Cohen, Bruce Melvin via phone (502) 551-2460.

Contact Information

Primary practice address
1939 Goldsmith Ln Ste 100 Louisville KY 40218-3090
Phone: (502) 873-7517
Fax: (502) 365-2876
Website:
Map and Directions
Authorized official contact:
Name: Cohen, Bruce Melvin
Phone: (502) 551-2460

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1285103937
LBN Legal business name A Newco Llc
DBA Doing business as Kentuckiana Center For Addiction Medicine
Authorized official Cohen, Bruce Melvin
Entity Organization
Organization subpart 1 No
Enumeration date Nov 23rd, 2018
Last updated Apr 20th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285103937 NPPES
Kentucky Other 2144175 WELLCARE
Kentucky MEDICAID 7100598570 WELLCARE
Kentucky Other PDZ000000400708 WELLCARE
Kentucky Other 000001237803 WELLCARE

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