Retina Associates, Psc

LBN: Retina Associates, Psc
Retina Associates, Psc is an health care organization with primary practice located at 1536 Story Ave The Eye Care Institute Building, Louisville KY 40206-1738. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty. Retina Associates, Psc can be contacted via phone (502) 589-1500, or through Prussian, Mark M via phone (502) 589-1500.

Contact Information

Primary practice address
1536 Story Ave The Eye Care Institute Building Louisville KY 40206-1738
Phone: (502) 589-1500
Fax: (502) 589-1556
Website:
Map and Directions
Authorized official contact:
Name: Prussian, Mark M MBA, FACHE, COE
Phone: (502) 589-1500

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1136DT Kentucky
Eye and Vision Services Providers / Optometrist 152W00000X 1614DT Kentucky
Eye and Vision Services Providers / Optometrist 152W00000X 1613DT Kentucky
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 31573 Kentucky
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 28804 Kentucky
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 28590 Kentucky
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01043769 Indiana
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01043733 Indiana
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01040010 Indiana

Profile Details

NPI number 1285639666
LBN Legal business name Retina Associates, Psc
DBA Doing business as
Authorized official Prussian, Mark M MBA, FACHE, COE
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2005
Last updated Oct 15th, 2018 - about 6 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 1285639666 NPPES
Kentucky Other 779033591 GROUP OD MEDICAID NUMBER
Kentucky MEDICAID 100221560A GROUP OD MEDICAID NUMBER
Kentucky Other 1121048 GROUP OD MEDICAID NUMBER
Kentucky MEDICAID 65917502 GROUP OD MEDICAID NUMBER
Kentucky Other CF7698 GROUP OD MEDICAID NUMBER

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