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9900 Corporate Campus Dr Ste 3000 Louisville KY 40223-4060 | |
| (502) 791-9800 | |
| (502) 805-5900 |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 9900 Corporate Campus Dr Ste 3000, Louisville, Kentucky |
| Authorized Official Name and Position | Sarah Thomas (OWNER) |
| Authorized Official Contact | 5027919800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 785 Louisville KY 40201-0785 Ph: (502) 791-9800 | 9900 Corporate Campus Dr Ste 3000 Louisville KY 40223-4060 Ph: (502) 791-9800 |
| NPI Number | 1669234373 |
|---|---|
| Provider Enumeration Date | 01/29/2024 |
| Last Update Date | 08/09/2024 |
| Certification Date | 08/09/2024 |
| Medicare PECOS PAC ID | 9931632783 |
|---|---|
| Medicare Enrollment ID | O20241031002470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669234373 | NPI | - | NPPES |
| Provider Name | Sarah Ann Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629445705 PECOS PAC ID: 4486962693 Enrollment ID: I20151007001449 |
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