Healthcare Provider Details

I. General information

NPI: 1346296035
Provider Name (Legal Business Name): ASHLAND HOSPITAL COPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 N CAROL MALONE BLVD STE 100
GRAYSON KY
41143-1123
US

IV. Provider business mailing address

PO BOX 1595
ASHLAND KY
41105-1595
US

V. Phone/Fax

Practice location:
  • Phone: 606-474-7892
  • Fax: 606-474-0040
Mailing address:
  • Phone: 606-408-4000
  • Fax: 606-408-3719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SARA MARKS
Title or Position: CEO
Credential:
Phone: 606-408-4404