MEDICARE: HOSPICE OF THE BLUEGRASS, 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	251B00000X	Case Management Agency	150056	KY
2	251K00000X	Public Health or Welfare Agency		KY
3	252Y00000X	Early Intervention Provider Agency	150056	KY
4	251E00000X	Home Health Agency	150056	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659374510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF THE BLUEGRASS, INC.

Provider Business Mailing Address
First Line	:	1733 HARRODSBURG ROAD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3617
Country	:	US
Telephone Number	:	859-234-8750
Fax Number	:	859-296-4101

Provider Business Practice Location Address
First Line	:	1317 US HIGHWAY 62E
Second Line	:
City	:	CYNTHIANA
State	:	KY
Zip	:	41031-7970
Country	:	US
Telephone Number	:	859-276-5344
Fax Number	:	859-234-8671

Authorized Official
Title or Position	:	CFO/VP OF FINANCE
Name	:	HOLLY SHRIVER HODGE
Credential	:
Telephone Number	:	859-296-6826

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	01/05/2024

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