Provider Demographics
NPI:1871045682
Name:BLUEGRASS TRANSIT, LLC
Entity Type:Organization
Organization Name:BLUEGRASS TRANSIT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:NUNNELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-475-6424
Mailing Address - Street 1:PO BOX 188
Mailing Address - Street 2:
Mailing Address - City:FLAT LICK
Mailing Address - State:KY
Mailing Address - Zip Code:40935-0188
Mailing Address - Country:US
Mailing Address - Phone:502-475-6424
Mailing Address - Fax:
Practice Address - Street 1:522 HIGHWAY 1137
Practice Address - Street 2:
Practice Address - City:CAWOOD
Practice Address - State:KY
Practice Address - Zip Code:40815-5233
Practice Address - Country:US
Practice Address - Phone:502-475-6424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4114343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)