Healthcare Provider Details
I. General information
NPI: 1881742401
Provider Name (Legal Business Name): OUR LADY OF BELLEFONTE HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/08/2007
Last Update Date: 02/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1005 E RING RD
IRONTON OH
45638-9610
US
IV. Provider business mailing address
8580 MAGELLAN PKWY
RICHMOND VA
23227-1149
US
V. Phone/Fax
- Phone: 740-533-9010
- Fax: 740-533-0982
- Phone: 804-627-5462
- Fax: 866-449-0896
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 150098 |
| License Number State | KY |
VIII. Authorized Official
Name:
LAURA
BUCZKOWSKI
Title or Position: CFO
Credential:
Phone: 410-442-3373