Healthcare Provider Details

I. General information

NPI: 1033328232
Provider Name (Legal Business Name): HOSPICE OF THE BLUEGRASS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 05/18/2023
Certification Date: 05/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 HARRODSBURG RD
LEXINGTON KY
40504-3617
US

IV. Provider business mailing address

1733 HARRODSBURG RD
LEXINGTON KY
40504-3617
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5344
  • Fax:
Mailing address:
  • Phone: 859-276-5344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number400013
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number400013
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number400013
License Number StateKY
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateKY
# 5
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number400013
License Number StateKY

VIII. Authorized Official

Name: HOLLY S HODGE
Title or Position: VP FINANCE/CHIEF FINANCIAL OFFICER
Credential: MBA, CPA
Phone: 859-276-5344