Provider Demographics
NPI:1902195233
Name:BLUEGRASS BUSINESS HEALTH
Entity type:Organization
Organization Name:BLUEGRASS BUSINESS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:TRAVIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-868-6106
Mailing Address - Street 1:1150 LEXINGTON RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8300
Mailing Address - Country:US
Mailing Address - Phone:502-570-0015
Mailing Address - Fax:502-570-0016
Practice Address - Street 1:1150 LEXINGTON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8300
Practice Address - Country:US
Practice Address - Phone:502-570-0015
Practice Address - Fax:502-570-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty