Healthcare Provider Details

I. General information

NPI: 1770752123
Provider Name (Legal Business Name): ASHLAND CENTER FOR WOMEN'S HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 23RD ST STE 415
ASHLAND KY
41101-2880
US

IV. Provider business mailing address

PO BOX 1327
ASHLAND KY
41105-1327
US

V. Phone/Fax

Practice location:
  • Phone: 606-325-6888
  • Fax:
Mailing address:
  • Phone: 606-325-6888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number1830339
License Number StateKY

VIII. Authorized Official

Name: DR. RICHARD FORD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 606-325-6888