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Organization

BLUEGRASS I.V. CARE, INC.

Active
Other names
Bluegrass Home Medical
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY S RUSSELL RPH (PRESIDENT)
(270) 825-2775
Entity
Organization

Contact information

Practice address
1128 N MAIN ST, SUITE 2, MADISONVILLE, KY 42431-1265
(270) 825-9661
(270) 825-3692
Mailing address
1128 N MAIN ST, SUITE 2, MADISONVILLE, KY 42431-1265
(270) 825-9661
(270) 825-3692

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
MG0250
KY
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
90060542
KY
Enumeration date
10/17/2006
Last updated
10/13/2009
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