PREMISE HEALTH OF WEST VIRGINIA MEDICAL MEDICAL CORPORATION NPI 1598349516

NPI Information

PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION is a multi-specialty clinic center in Louisville, KY. PREMISE HEALTH OF WEST VIRGINIA MEDICAL, MEDICAL CORPORATION NPI is 1598349516. The provider is registered as an organization entity type.
The provider Is Doing Business As Humana Health & Well-being Center Humana Tower.

The provider's business location address is:

500 W MAIN ST
LOUISVILLE, KY
ZIP 40202-946
Phone: (502) 476-3335
Fax: (502) 509-6954

The provider's authorized official is Jonathan B Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 18D2226608 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/6/2021 and was last updated on 8/15/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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