Provider Demographics
NPI:1821506510
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 1:20 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-1840
Mailing Address - Country:US
Mailing Address - Phone:859-987-3272
Mailing Address - Fax:859-987-3273
Practice Address - Street 1:2900 DOLPHIN DR STE 102
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7113
Practice Address - Country:US
Practice Address - Phone:800-470-4757
Practice Address - Fax:502-331-6271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
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