A NEWCO LLC NPI 1285103937

NPI Information

A NEWCO LLC is an addiction medicine psychiatry neurology in Louisville, KY. The provider is a doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine A NEWCO LLC NPI is 1285103937. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Kentuckiana Center For Addiction Medicine.

The provider's business location address is:

1939 GOLDSMITH LN STE 100
LOUISVILLE, KY
ZIP 40218-090
Phone: (502) 873-7517
Fax: (502) 365-2876

The provider's authorized official is Bruce Melvin Cohen .
The authorized official title is Member and has the following contact phone number (502) 551-2460.

The CLIA number assigned to this NPI record is 18D2222564 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/23/2018 and was last updated on 4/20/2021.

Taxonomy Codes

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