Healthcare Provider Details

I. General information

NPI: 1275790230
Provider Name (Legal Business Name): KENTUCKY HOSPITAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2008
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 W LEXINGTON AVE
WINCHESTER KY
40391-1169
US

IV. Provider business mailing address

1107 W LEXINGTON AVE
WINCHESTER KY
40391-1169
US

V. Phone/Fax

Practice location:
  • Phone: 859-745-3500
  • Fax: 859-745-3450
Mailing address:
  • Phone: 859-745-3500
  • Fax: 859-745-3450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateKY

VIII. Authorized Official

Name: MR. ROBERT DONALD FRARACCIO
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 859-745-3500