Healthcare Provider Details

I. General information

NPI: 1952401218
Provider Name (Legal Business Name): HENRY COUNTY MEDICAL CENTER PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 12/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SO MAIN ST.
NEW CASTLE KY
40050
US

IV. Provider business mailing address

15 SOUTH MAIN STREET BOX 189
NEW CASTLE KY
40050-0189
US

V. Phone/Fax

Practice location:
  • Phone: 502-845-7550
  • Fax: 502-845-5551
Mailing address:
  • Phone: 502-845-7550
  • Fax: 502-845-5551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. RONALD M KOFF
Title or Position: OWNER
Credential: M.D.
Phone: 502-845-0369