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Rafi A Hasan

Internal Medicine

Allopathic & Osteopathic Physicians

250 E Liberty St, Ste200, Louisville, KY 40202-1530

PECOS Enrollment

This provider is enrolled in PECOS as RAFI HASAN.

Based on the most recent information from CMS, provider Rafi A Hasan is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1700864329
Provider Type
Individual
Full Name
Hasan, Rafi A
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
1/4/2006
Last Updated
8/6/2013

Contact Information

Practice Location

250 E Liberty St, Ste200, Louisville, KY 40202-1530

(502) 568-6722

(502) 568-6733

Mailing Location

250 E Liberty St, Ste 200, Louisville, KY 40202-1530

(502) 568-6722

(502) 568-6733

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License 34260 Kentucky

Provider Identifiers

ID	Description	Issuer
ID 64016033	Description Medicaid	Issuer Unlisted Kentucky

Rafi A Hasan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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Chaudhary, Sirmad Bashir