Provider Demographics
NPI:1427037712
Name:OWENSBORO HEALTH INC
Entity Type:Organization
Organization Name:OWENSBORO HEALTH INC
Other - Org Name:OWENSBORO HEALTH HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCIAL SERVICE
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:RANALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-685-7180
Mailing Address - Street 1:1201 PLEASANT VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-9811
Mailing Address - Country:US
Mailing Address - Phone:270-417-2000
Mailing Address - Fax:
Practice Address - Street 1:2816 VEACH RD STE 303
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-6297
Practice Address - Country:US
Practice Address - Phone:270-688-2182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-13
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150112251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY34006304Medicaid
IN200134380Medicaid
18-7112Medicare ID - Type Unspecified
IN200134380Medicaid