Healthcare Provider Details

I. General information

NPI: 1922325513
Provider Name (Legal Business Name): HOSPICE OF THE BLUEGRASS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/21/2020
Certification Date: 04/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 HARRODSBURG RD
LEXINGTON KY
40504-3667
US

IV. Provider business mailing address

1733 HARRODSBURG RD
LEXINGTON KY
40504-3667
US

V. Phone/Fax

Practice location:
  • Phone: 859-276-5344
  • Fax: 859-296-4101
Mailing address:
  • Phone: 859-276-5344
  • Fax: 859-296-4101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number41461
License Number StateKY

VIII. Authorized Official

Name: MS. HOLLY SHRIVER HODGE
Title or Position: VP FINANCE, CFO
Credential:
Phone: 859-276-5344