MEDICARE: OHIO COUNTY HOSPITAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician

General Provider Information

NPI Number	:	1215884705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO COUNTY HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 148
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-0148
Country	:	US
Telephone Number	:	270-504-1910
Fax Number	:	270-298-3824

Provider Business Practice Location Address
First Line	:	1211 OLD MAIN ST
Second Line	:
City	:	HARTFORD
State	:	KY
Zip	:	42347-1619
Country	:	US
Telephone Number	:	270-298-7411
Fax Number	:	270-298-3824

Authorized Official
Title or Position	:	CREDENTIALING
Name	:	DANA LANDRUM
Credential	:
Telephone Number	:	270-504-1940

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “OHIO COUNTY HOSPITAL CORPORATION ” Practice Location

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