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Louisville Optometric Centers, III PSC

Organization Active NPI Eyewear Supplier · Louisville, KY

NPI 1669545554 · NPPES record last updated Feb 19, 2014

Key facts

NPI
1669545554
Entity type
Organization (NPI type 2)
Primary specialty
Eyewear Supplier 332H00000X
License
5419240010 (KY)
Legal business name
LOUISVILLE OPTOMETRIC CENTERS, III PSC
Practice address
4000 Poplar Level Rd
Louisville, KY 40213-1524
Phone
(502) 459-2020
Fax
(502) 456-9121
NPI assigned
Nov 16, 2006
Organization subpart
No

Authorized official

Name
Dr. Rod L. Rallo, O.D.
Title
Owner and Optometrist
Phone
(502) 459-2020

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 18

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 32

Organizations that report the same tax identification number in the National Provider Directory.

View all 32

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 38

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Visionfirst
4000 Poplar Level Rd, Louisville, KY 40213-1524 · (502) 451-0332		 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignment
Participating since Jan 1, 2005

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930069187 KY DME Supplier - Physician - Optometrist
DME Supplier - Optician		 8729041926 1 other NPI on this enrollment
Practice locations: Louisville, KY

National Provider Directory

Tax ID family
Louisville Optometric I (33 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 5419240010 KY Yes

Addresses

Primary practice location

4000 Poplar Level Rd
Louisville, KY 40213-1524

Mailing address

4000 Poplar Level Rd
Louisville, KY 40213-1524
Phone (502) 459-2020

Other names

  • VisionFirst Doing business as

Other providers in Louisville, KY

All providers in Louisville, KY · Eyewear Supplier in Kentucky

Sources for this page

Verify at the official NPI Registry.