MEDICARE: BLUEGRASS OXYGEN INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		KY

General Provider Information

NPI Number	:	1336253830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUEGRASS OXYGEN INC

Provider Business Mailing Address
First Line	:	983 PRIMROSE CT
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40511-1232
Country	:	US
Telephone Number	:	859-277-2583
Fax Number	:	859-277-5454

Provider Business Practice Location Address
First Line	:	25 MEDICAL LANE
Second Line	:
City	:	WHITLEY CITY
State	:	KY
Zip	:	42653-4216
Country	:	US
Telephone Number	:	606-376-2046
Fax Number	:	866-578-0202

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CRAIG A. COLEMAN
Credential	:	RRT
Telephone Number	:	859-277-2583

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/21/2022

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Directions to “BLUEGRASS OXYGEN INC ” Practice Location

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