OrganizationAmin'S Family Practice Associates , PscNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1505 S 7th St, Louisville, KY 40208-1710(502) 637-1005PECOS EnrollmentBased on the most recent information from CMS, provider Amin'S Family Practice Associates , Psc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1750307393Provider TypeOrganizationFull NameAmin'S Family Practice Associates , PscSubpartNoEnumeration Date7/15/2006Last Updated5/2/2014Contact InformationPractice LocationPractice Address1505 S 7th St, Louisville, KY 40208-1710Phone(502) 637-1005Fax(502) 635-0046Mailing LocationMailing Address1505 S 7th St, Louisville, KY 40208-1710Phone(502) 637-1005Fax(502) 635-0046Authorized OfficialNameAmin, Rajan R (President)Phone(502) 637-1005Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerCode207Q00000XDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense19340KentuckyCode208D00000XDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode363LA2100XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID1050007DescriptionOtherIssuerPASSPORT HEALTH PLANKentuckyID2432749001DescriptionOtherIssuerPASSPORT ADVANTAGEKentuckyID2432748001DescriptionOtherIssuerPASSPORT ADVANTAGEKentuckyID1050006DescriptionOtherIssuerPASSPORT HEALTH PLANKentuckyID65911745DescriptionMedicaidIssuerUnlistedKentuckyID2432747001DescriptionOtherIssuerPASSPORT ADVANTAGEKentuckyID1050005DescriptionOtherIssuerPASSPORT HEALTH PLANKentucky