=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881864338
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OHIO COUNTY HOSPITAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2008
-----------------------------------------------------
Last Update Date | 03/19/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1211 MAIN ST
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42347-1619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-298-7411
-----------------------------------------------------
Fax | 270-298-5269
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1211 MAIN ST P.O. BOX 126
-----------------------------------------------------
City | HARTFORD
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42347-1619
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-298-7411
-----------------------------------------------------
Fax | 270-298-5269
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PFS DIRECTOR
-----------------------------------------------------
Name | MRS. JENNIFER DAUGHERTY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 270-504-1910
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------