| Uma Primary Care, Llc | |
|
401 E Chestnut St #370 Louisville KY 40202-5700 | |
| (502) 562-6510 | |
| (502) 562-6515 |
| Full Name | Uma Primary Care, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 401 E Chestnut St, Louisville, Kentucky |
| Authorized Official Name and Position | Jesse Roman (PRESIDENT) |
| Authorized Official Contact | 5028525241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Uma Primary Care, Llc 501 E Broadway #290 Louisville KY 40202-1785 Ph: (502) 217-8221 | Uma Primary Care, Llc 401 E Chestnut St #370 Louisville KY 40202-5700 Ph: (502) 562-6510 |
| NPI Number | 1518121458 |
|---|---|
| Provider Enumeration Date | 07/10/2008 |
| Last Update Date | 07/08/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518121458 | NPI | - | NPPES |
| 7100106840 (ARNPS) | Medicaid | KY | |
| 50020522 | Other | KY | PASSPORT HEALTH PLAN |
| 7100050240 (MDS) | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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