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General NPI Number Information
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NPI Number | 1760831200
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Entity Type | Organization
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Legal Business Name | BLUEGRASS HEARING CLINIC, LLC
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Dates
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Enumeration Date | 06/06/2016
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 202 W STEPHEN FOSTER AVE STE A
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City | BARDSTOWN
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State | KY
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Zip | 40004-1466
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Country | US
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Telephone | 502-331-6270
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Fax | 502-331-6271
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Provider Business Mailing Address
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Address Line | 116 MERIDIAN WAY STE 1
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City | RICHMOND
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State | KY
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Zip | 40475-2876
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Country | US
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Telephone | 859-623-4458
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Fax | 859-623-4459
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Authorized Official
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Title or Position | OWNER/CEO
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Name | SHERRY MCCALL LANTER
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Credential |
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Telephone | 859-987-3272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231HA2400X
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Taxonomy Name | Assistive Technology Practitioner Audiologist
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License Number |
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License Number State |
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