Healthcare Provider Details

I. General information

NPI: 1366913337
Provider Name (Legal Business Name): ASHLAND HOSPITAL COPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2018
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SCIOTO TRL STE 200
PORTSMOUTH OH
45662-2845
US

IV. Provider business mailing address

PO BOX 1595
ASHLAND KY
41105-1595
US

V. Phone/Fax

Practice location:
  • Phone: 403-548-8377
  • Fax: 740-353-7943
Mailing address:
  • Phone: 740-354-8930
  • Fax: 740-354-7900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SARA MARKS
Title or Position: CEO/PRESIDENT
Credential:
Phone: 606-408-4401