Provider Demographics
NPI:1730368291
Name:NEWBURG SERVICES INC
Entity type:Organization
Organization Name:NEWBURG SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-326-3673
Mailing Address - Street 1:1301 CLEAR SPRING TRACE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-3855
Mailing Address - Country:US
Mailing Address - Phone:502-326-3673
Mailing Address - Fax:502-326-3674
Practice Address - Street 1:1301 CLEAR SPRING TRACE
Practice Address - Street 2:SUITE 104
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-3855
Practice Address - Country:US
Practice Address - Phone:502-326-3673
Practice Address - Fax:502-326-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-31
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6056970001Medicare NSC