Provider Demographics
NPI:1164499927
Name:LOUISVILLE PULMONARY CARE PLLC
Entity type:Organization
Organization Name:LOUISVILLE PULMONARY CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MAIN MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:HALLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:502-899-7377
Mailing Address - Street 1:4003 KRESGE WAY
Mailing Address - Street 2:SUITE 312
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207
Mailing Address - Country:US
Mailing Address - Phone:502-899-7377
Mailing Address - Fax:502-899-1972
Practice Address - Street 1:4003 KRESGE WAY STE 312
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4652
Practice Address - Country:US
Practice Address - Phone:502-899-7377
Practice Address - Fax:502-899-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1079138OtherPASSPORT
KY65931917Medicaid
KY65931917Medicaid
KY65931917Medicaid