Pearl Medical Practice Pllc
LBN: Pearl Medical Practice Pllc
Pearl Medical Practice Pllc is an health care organization with primary practice located at 4200 Gardiner View Ave Suite 200, Louisville KY 40213-1877. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty.
Pearl Medical Practice Pllc can be contacted via phone (502) 456-0494, or through Omoruyi, Osawaru via phone (502) 456-0494.
Contact Information
Primary practice address
4200 Gardiner View Ave Suite 200
Louisville KY 40213-1877
Phone: (502) 456-0494
Fax: (502) 456-0496
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | ||
Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | ||
Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | ||
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X |
Profile Details
NPI number | 1114261203 |
---|---|
LBN Legal business name | Pearl Medical Practice Pllc |
DBA Doing business as | |
Authorized official | Omoruyi, Osawaru Doctor of Medicine (MD) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Nov 15th, 2012 |
Last updated | Oct 2nd, 2015 - about 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114261203 | NPPES |
Kentucky | MEDICAID | 7100267920 | |
Kentucky | MEDICAID | 7100259660 |
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