Provider Demographics
NPI:1093347643
Name:CONUNDRUM, INC
Entity Type:Organization
Organization Name:CONUNDRUM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:859-308-6018
Mailing Address - Street 1:107 FRAZIER CT STE 2B
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-8973
Mailing Address - Country:US
Mailing Address - Phone:502-542-0014
Mailing Address - Fax:
Practice Address - Street 1:107 FRAZIER CT STE 2B
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-8973
Practice Address - Country:US
Practice Address - Phone:859-963-1842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONUNDRUM, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7205516OtherSTATE LICENSURE