Organization · NPI-2

Jencare Neighborhood Medical Center West Broadway, LLC

Specialist · Louisville, KY

NPI number1740540525
StatusActive
Last updated in NPPESOct 31, 2024

Details

NPI
1740540525
Entity type
Organization (NPI-2)
Legal business name
Jencare Neighborhood Medical Center West Broadway, LLC
Organization subpart
No
Enumeration date
May 25, 2012
Certification date
Oct 31, 2024
Last updated
Oct 31, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
174400000X Specialist––Yes
332900000X Non-Pharmacy Dispensing Site––

Other names

  • Jencare Neighborhood Medical Center (Doing Business As)

Practice location

2406 W Broadway
Louisville, KY 40211-1008

Phone 305-653-1770

Mailing address

1395 Nw 167th St
Miami, FL 33169-5710

Phone 305-621-6117

Authorized official

Mary Chen
Exective Vp
3058314722

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