Healthcare Provider Details

I. General information

NPI: 1124007414
Provider Name (Legal Business Name): OWENSBORO HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 FORD AVE
OWENSBORO KY
42301-4677
US

IV. Provider business mailing address

1201 PLEASANT VALLEY RD
OWENSBORO KY
42303-9811
US

V. Phone/Fax

Practice location:
  • Phone: 270-683-9355
  • Fax:
Mailing address:
  • Phone: 270-417-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number
License Number State

VIII. Authorized Official

Name: MR. RUSS RANALLO
Title or Position: VICE PRESIDENT OF FINANCIAL SERVICE
Credential:
Phone: 270-685-7180