| Longevity Clinical Ltc Associates Of Kentucky, Pllc | |
|
2100 Cherokee Ridge Way Ste 100 Louisville KY 40205-1600 | |
| (502) 667-8150 | |
| Not Available |
| Full Name | Longevity Clinical Ltc Associates Of Kentucky, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 2100 Cherokee Ridge Way Ste 100, Louisville, Kentucky |
| Authorized Official Name and Position | Diane Vincur (MANAGER) |
| Authorized Official Contact | 5618152427 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Clinical Ltc Associates Of Kentucky, Pllc 11780 Us Highway 1 Ste N107 North Palm Beach FL 33408-3007 Ph: (561) 815-2427 | Longevity Clinical Ltc Associates Of Kentucky, Pllc 2100 Cherokee Ridge Way Ste 100 Louisville KY 40205-1600 Ph: (502) 667-8150 |
| NPI Number | 1932935798 |
|---|---|
| Provider Enumeration Date | 09/10/2024 |
| Last Update Date | 09/10/2024 |
| Medicare PECOS PAC ID | 9830623446 |
|---|---|
| Medicare Enrollment ID | O20241105002047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932935798 | NPI | - | NPPES |
| Provider Name | Sarah Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194116038 PECOS PAC ID: 4880911429 Enrollment ID: I20150319002389 |
| Provider Name | Desiree F Albritton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023550761 PECOS PAC ID: 0749565067 Enrollment ID: I20170328001612 |
| Provider Name | Kathy Gallaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114436540 PECOS PAC ID: 1153660295 Enrollment ID: I20190306003439 |
| Provider Name | La'kia Singleton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326411448 PECOS PAC ID: 6608179023 Enrollment ID: I20231016001634 |
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