Healthcare Provider Details

I. General information

NPI: 1093762619
Provider Name (Legal Business Name): ASHLAND HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 W TOM T HALL BLVD
OLIVE HILL KY
41164-7688
US

IV. Provider business mailing address

2201 LEXINGTON AVE PO BOX 1595
ASHLAND KY
41101-2843
US

V. Phone/Fax

Practice location:
  • Phone: 606-286-8039
  • Fax: 606-286-6108
Mailing address:
  • Phone: 606-327-5044
  • Fax: 606-327-7425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SARA MARKS
Title or Position: CEO
Credential:
Phone: 606-408-4000