Healthcare Provider Details

I. General information

NPI: 1912724238
Provider Name (Legal Business Name): OWENSBORO HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2024
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 EAST PARRISH AVE BLDG C SUITE LL102
OWENSBORO KY
42303
US

IV. Provider business mailing address

2200 EAST PARRISH AVE BLDG C SUITE LL102
OWENSBORO KY
42303
US

V. Phone/Fax

Practice location:
  • Phone: 270-688-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. RUSS RANALLO
Title or Position: CFO
Credential:
Phone: 270-685-7180