OrganizationActive
Commonwealth of Kentucky
NPI 1114346467 · Multi-Specialty Clinic/Center · Louisville, KY
Provider details
- NPI number
- 1114346467
- Entity type
- Organization
- Primary specialty
- Multi-Specialty Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Commonwealth of Kentucky
- Organization subpart
- Yes
- Authorized official
- Jennifer Moore, Assistant Director(502) 782-6117
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1800 Bluegrass Ave
Louisville, KY 40215-1130
Phone: (502) 361-2301
Fax: (502) 366-0367
Approximate (ZIP-level) locationGet directions
Mailing address
1800 Bluegrass Ave
Louisville, KY 40215-1130
Other names (DBA / former)
- Other name
- Hazelwood Specialty Clinic
- Doing business as
- Hazelwood Specialty Clinic
- Other name
- Hazelwood Specialty Clinic
Registry dates
- Enumerated
- 2014-04-15
- Last updated
- 2024-08-07
- Certified
- 2024-08-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.