Healthcare Provider Details

I. General information

NPI: 1881021772
Provider Name (Legal Business Name): OUR LADY OF BELLEFONTE HOSPITAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2013
Last Update Date: 07/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SAINT CHRISTOPHER DR
ASHLAND KY
41101-7055
US

IV. Provider business mailing address

1100 SAINT CHRISTOPHER DR
ASHLAND KY
41101-7055
US

V. Phone/Fax

Practice location:
  • Phone: 606-833-6713
  • Fax:
Mailing address:
  • Phone: 606-833-6713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: JASON ASIC
Title or Position: COO
Credential:
Phone: 513-215-0203