Healthcare Provider Details

I. General information

NPI: 1447395090
Provider Name (Legal Business Name): OUR LADY OF BELLEFONTE HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 ARGILLITE RD
FLATWOODS KY
41139-1972
US

IV. Provider business mailing address

PO BOX 2155
ASHLAND KY
41105-2155
US

V. Phone/Fax

Practice location:
  • Phone: 606-836-3900
  • Fax: 606-836-0205
Mailing address:
  • Phone: 606-833-4680
  • Fax: 606-833-4668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5061
License Number StateKY

VIII. Authorized Official

Name: LORI K MILLER
Title or Position: OFFICE MANAGER
Credential:
Phone: 606-833-8640