Contract Details
Facility name
Preferred Medical Network
Provider ID
P000002345
NPI
1750529582
Tax ID
311573142
Effective Date
12/15/2010
Last Updated
10/26/2016
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_283
Location Details
Address
2400 Bush Ridge Drive
Louisville, KY 40245
United States
County
Jefferson
Phone
5024895233 (Phone)
Billing Details
Address
309 Townepark Circle
Suite 100
Louisville, KY 40243
Billing Phone
Specialty Type
Durable Medical Equipment & Medical Supplies
Map
Address