Provider Demographics
NPI:1063656544
Name:BLUEGRASS MEDICAL EQUIPMENT, LLC.
Entity type:Organization
Organization Name:BLUEGRASS MEDICAL EQUIPMENT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-450-0867
Mailing Address - Street 1:3160 PARISA DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-4503
Mailing Address - Country:US
Mailing Address - Phone:270-450-0867
Mailing Address - Fax:270-450-0868
Practice Address - Street 1:3160 PARISA DR
Practice Address - Street 2:SUITE F
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-4503
Practice Address - Country:US
Practice Address - Phone:270-450-0867
Practice Address - Fax:270-450-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6387410001Medicare NSC