Organization
BLUEGRASS ORTHOTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GEORGIA A MARSHALL (OWNER)
(859) 824-1000
Entity
Organization
Contact information
Practice address
1116 NORTH MAIN STREET, WILLIAMSTOWN, KY 41097-8503
(859) 824-1000
(859) 824-1555
Mailing address
PO BOX 97, WILLIAMSTOWN, KY 41097-0097
(859) 824-1000
(859) 824-1555
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
10/16/2006
Last updated
10/24/2011
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