Healthcare Provider Details

I. General information

NPI: 1902364607
Provider Name (Legal Business Name): BLUEGRASS HEARING INSTITUTE, PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 05/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 HOSPITAL DR STE 265
WINCHESTER KY
40391-7645
US

IV. Provider business mailing address

225 HOSPITAL DR STE 265
WINCHESTER KY
40391-7645
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-1010
  • Fax: 859-745-0080
Mailing address:
  • Phone: 859-745-1010
  • Fax: 859-745-0080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: ARA MAKDESSIAN
Title or Position: OWNER
Credential:
Phone: 859-745-1010