Organization
VARGO ENTERPRISES INC
Active
Other names
Bourbon Medical Lab & X-Ray
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HENRIETTA RUTH GREY CLS (LAB MANAGER)
(859) 987-1665
Entity
Organization
Contact information
Practice address
2017 SOUTH MAIN, PARIS, KY 40361
(859) 987-1665
(859) 987-3064
Mailing address
2017 SOUTH MAIN, PARIS, KY 40361
(859) 987-1665
(859) 987-3064
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
896
KY
291U00000X
Clinical Medical Laboratory
200122
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37902483
—
KY
05
—
86000916
—
KY
Enumeration date
10/23/2006
Last updated
09/26/2008
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