Provider Demographics
NPI:1538536420
Name:BLUEGRASS HEARING CLINIC, LLC
Entity type:Organization
Organization Name:BLUEGRASS HEARING CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:MCCALL
Authorized Official - Last Name:LANTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-987-3272
Mailing Address - Street 1:116 MERIDIAN WAY STE 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2876
Mailing Address - Country:US
Mailing Address - Phone:859-623-4458
Mailing Address - Fax:859-623-4459
Practice Address - Street 1:3940 S DANVILLE BYP
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2529
Practice Address - Country:US
Practice Address - Phone:859-236-3865
Practice Address - Fax:859-236-1690
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUEGRASS HEARING CLINIC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-26
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Single Specialty