MEDICARE: OHIO COUNTY HOSPITAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC0060X	Critical Access Hospital	600073	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1059060	OTHER	KY	KEYSTONE MERCY PASSPORT
2	000000061904	OTHER	KY	BLUE CROSS LAB PIN NUMB
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000054290	OTHER	KY	BLUE CROSS HOSP PIN NUM
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	030024700	OTHER	KY	FEDERAL BLACK LUNG
7	000000055515	OTHER	KY	BLUE CROSS PROFESSIONAL

General Provider Information

NPI Number	:	1629007430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO COUNTY HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	1211 OLD MAIN ST
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-1619
Country	:	US
Telephone Number	:	270-298-5431
Fax Number	:	270-298-5269

Provider Business Practice Location Address
First Line	:	1211 OLD MAIN ST
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-1619
Country	:	US
Telephone Number	:	270-298-5431
Fax Number	:	270-298-5269

Authorized Official
Title or Position	:	PFS DIRECTOR
Name	:	MRS. JENNIFER DAUGHERTY
Credential	:
Telephone Number	:	270-504-1910

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	03/19/2024

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Directions to “OHIO COUNTY HOSPITAL CORPORATION ” Practice Location

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