BUC INDEPENDENCE LLC NPI 1417330150

NPI Information

NPI: 1417330150
Provider Name: BUC INDEPENDENCE LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 18D1097867

Address:
2025 DECLARATION DR
INDEPENDENCE, KY
ZIP 41051
Phone: (859) 371-7900
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BUC INDEPENDENCE LLC is an urgent care clinic center in Independence, KY. BUC INDEPENDENCE LLC NPI is 1417330150. The provider is registered as an organization entity type.

The provider's business location address is:

2025 DECLARATION DR
INDEPENDENCE, KY
ZIP 41051-983
Phone: (859) 371-7900
Fax: (859) 371-0489

The provider's authorized official is Robert R So .
The authorized official title is Owner and has the following contact phone number (859) 485-7900.

The CLIA number assigned to this NPI record is 18D1097867 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/30/2015 and was last updated on 12/15/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	261QU0200X	Clinic/Center	Urgent Care	Yes
2	291U00000X	Clinical Medical Laboratory		No
3	332B00000X	Durable Medical Equipment & Medical Supplies		No
4	363A00000X	Physician Assistant		No
5	363L00000X	Nurse Practitioner		No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	7100408220	MEDICAID	KENTUCKY
2	K137200	MEDICARE PIN	KENTUCKY
3	7100423920	MEDICAID	KENTUCKY
4	0152735	MEDICAID	OHIO
5	7100399770	MEDICAID	KENTUCKY
6	6410700002	MEDICARE NSC	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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