Organization · NPI-2

502 Eye Care LLC

Clinic/Center · Louisville, KY

NPI number1174378145
StatusActive
Last updated in NPPESApr 22, 2024

Details

NPI
1174378145
Entity type
Organization (NPI-2)
Legal business name
502 Eye Care LLC
Organization subpart
No
Enumeration date
Apr 22, 2024
Certification date
Apr 22, 2024
Last updated
Apr 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

3408 Bardstown Rd
Louisville, KY 40218-4608

Phone 502-912-9884

Mailing address

3236 Wynbrooke Cir
Louisville, KY 40241-3124

Phone 502-345-0445

Authorized official

Jubin Shah
Optometrist
5029129884

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